Patient dies in my hands...

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Specializes in LTC.

long story short: today was my day as team leader, therefore i basically assigned patients and helped out all my class mates. i was going in with one of my nursing students with my instructor to watch her give meds and i also brought a oral suctioner ( forgot the technical name) to help the patient clear his mouth of all the sputum he was bringing up. with out going into much detail the patient had lung cancer and a dvt. the patient was also in our care yesterday and he appeared to be a very nice and talkative gentlemen. he was alert and oriented times 3 even up to his death. ok, now back to the story: so me, my instructor, and the other nursing student are in the room and then i start to do some patient teaching about using the oral suctioner. at first he was nervous and was apprenhensive about using it, but i explained that it will help him to clear his mouth instead of having to spit in the basin ( which got pretty full at times). before i can even hook up the suctioner to the vacumm he started spitting up sputum. at the time my instructor stepped out for a quick second and it was just me in the student nurse. he then started to spit up large amounts of blood at the time the student nurse got my instructor and the patients nurse and eventally the whole code team came. before they arrive the student nurse, instructor, and i was pretty much at his side trying to help him sit up to prevent aspiration. he was very anxious and tried to get oob so i was there to make sure he stayed safe. the look on his face was just devastating he was literally not able to grasp his breath due to the large amt. of blood coming up. he eventally seized and then died. this all happened in less then 10 minutes. all i can do was stay with him and make sure he was safe. i had my hand on his back trying to support him in a high fowlers position along with the head of the bed being up. ofcourse the medical team came in and assessed him and pronounced him dead. they couldn't do anything because he was a dnr. this all happened so fast. i just couldn't believe how quickly he changed. the nurse suspected that the dvt caused the pt. to have a pulmonary emboli. just imagine someone being talkative, smiling, alert, and then within the next 5 minutes dying. :crying2: so what a day. just thought i would share my clinical experience.

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Specializes in ICU.
he then started to spit up large amounts of blood at the time the student nurse got my instructor and the patients nurse and eventally the whole code team came. before they arrive the student nurse, instructor, and i was pretty much at his side trying to help him sit up to prevent aspiration. he was very anxious and tried to get oob so i was there to make sure he stayed safe. the look on his face was just devastating he was literally not able to grasp his breath due to the large amt. of blood coming up. he eventally seized and then died. this all happened in less then 10 minutes. all i can do was stay with him and make sure he was safe. i had my hand on his back trying to support him in a high fowlers position along with the head of the bed being up. ofcourse the medical team came in and assessed him and pronounced him dead. they couldn't do anything because he was a dnr. this all happened so fast. i just couldn't believe how quickly he changed. the nurse suspected that the dvt caused the pt. to have a pulmonary emboli. just imagine someone being talkative, smiling, alert, and then within the next 5 minutes dying. :crying2: so what a day. just thought i would share my clinical experience.

i'm sorry you had to go through that. it doesn't sound like a good way to go at all.:uhoh21:

with the pt's hx of lung ca, i suspect that he may have eroded a blood vessel in the lung, causing massive bleeding into his airway. on the rescue squad, i've responded to lung ca pts found down after exactly the same thing. imagine trying to clear the airway, with large amounts of clotted blood feeling like liver between my gloved fingers. no, my patient didn't make it either.

{soapbox warning} as painful as this was to watch, i hope that you take your patient's final message to heart. life is precious, and can end with zero warning. it happened to your patient today. it could happen to me or you tomorrow. i had a friend in her early 20's die after having a "minor" virus end up nuking her heart. this came less than a month after she had her first baby.

watching my patients on the ambulance go from awake/alert/talking, to full arrest & dead with little warning drove this lesson into my dinky little brain. this was also one of the reasons i quit a successful 22-year long engineering career to go into nursing. i was no longer happy in engineering, and wanted to do something that would both make me happy and challenge me to learn.

life is short, and can end with zero warning. make every day worthwhile. {ok, i'll step off my soapbox now.}

it is difficult to watch people die, especially if it's new to you. if this experience starts screwing with your mind, please seek help.

take care.

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Sounds like traumatic experience for you. It is always hard watching a patient die, but some are more traumatic than others.

You might find some helpful posts/comments in the Allnurses staff blog entitled Nurses Coping with Personal Grief.

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Specializes in LTC.

Thanks for the responses. I actually held myself together pretty well. At the time I had a huge adrenaline rush and however I maintained his safety and just supported him through his death. I have to admit that I kept getting a replay of the event all day but I'm over it now. That day reminded me why I chose nursing.

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I find its important to remember the importance of you being there during this time, this patient could have been going through this alone with no one in the room, in less then 10 minutes its quite likely that this could have transpired while the patient was completely alone and scared, I am willingly to bet that having nurses surounding him eased him even though his death was extremely traumatic.

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Specializes in Case Mgmt, Anesthesia, ICU, ER, Dialysis.

Above all, you did good. You remembered the most important priority: maintain that airway, and you did what you could to comfort him in his last moments. He had a friendly face and caring hands touching him.

Let me second what CrufflerJJ said: Life is short, and in the blink of an eye, the beat of a heart, it can be over.

You learned a very important part of nursing through this gentleman: It is as much a part of nursing to help people die as to help them live.

I would suggest that if you feel the need to talk about this, your instructor is a great resource, but the hospital's employee assistance program may be able to offer additional support from someone who is trained to help nurses who are faced with a traumatic death event, such as you describe.

Welcome to Nursing. We're glad to have you.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

The oral suction is called a Yankauer suction.

I had a CA patient who I helped to the bathroom. As soon as I got her back to bed she closed her eyes and passed away.

This kind of stuff happens with CA patients. I would rather die of a sudden heart attack or blood clot than whither away with pain and cachexia from a cancer.

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Many times throughout your career you will be the last face a patient sees before they pass. He was lucky to have someone so sweet and caring by his side when he died. {{{hugs}}}

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