Bereavement Chair Advice/ Help Nurse Cope with loss

meanmaryjean, DNP, RN · Sep 12, 2013

We have an unwritten but always followed policy: If your patient dies on your shift, after the family leaves, you may go home. No questions asked. I have only had one patient die thus far, and it was helpful.

Pediatric Critical Care Columnist · Sep 13, 2013

That's so far from what happens on our unit that you can't even see it from here. One night I had an infant 29 days old die in my arms. I'd been one of his primary nurses so it wasn't even a question that I would take him for the shift. He breathed his last less than an hour into the shift. After I'd done the post mortem care and all the paperwork had been done I stood by the bed looking at him when my manager came into the room and told me I had to send him to the morgue ASAP because I was taking over care of another kid at 11. On another shift I was supposed to be the resource nurse but ended up taking admission of an infant in cardiac arrest about 90 minutes into the shift. There were valiant efforts to cannulate for ECMO but ultimately they failed. The parents had already left the hospital when the arrest occurred and so we left messages for them at RMH and on their cell phones. Meanwhile I sat with the baby waiting for them. Eventually the charge nurse came to the room to tell me the manager had said I couldn't keep the body in the room, I had to take it to the conference room across the hall to wait. The family finally arrived at about midnight and we stayed in the conference room for more than an hour. There was never any suggestion that I should go home. As for debriefing... they arrange those for a time when most of the people involved are off, and I live too far away to drive in for something like that on my own time.

meanmaryjean, DNP, RN · Sep 13, 2013

That's so far from what happens on our unit that you can't even see it from here. One night I had an infant 29 days old die in my arms. I'd been one of his primary nurses so it wasn't even a question that I would take him for the shift. He breathed his last less than an hour into the shift. After I'd done the post mortem care and all the paperwork had been done I stood by the bed looking at him when my manager came into the room and told me I had to send him to the morgue ASAP because I was taking over care of another kid at 11. On another shift I was supposed to be the resource nurse but ended up taking admission of an infant in cardiac arrest about 90 minutes into the shift. There were valiant efforts to cannulate for ECMO but ultimately they failed. The parents had already left the hospital when the arrest occurred and so we left messages for them at RMH and on their cell phones. Meanwhile I sat with the baby waiting for them. Eventually the charge nurse came to the room to tell me the manager had said I couldn't keep the body in the room, I had to take it to the conference room across the hall to wait. The family finally arrived at about midnight and we stayed in the conference room for more than an hour. There was never any suggestion that I should go home. As for debriefing... they arrange those for a time when most of the people involved are off, and I live too far away to drive in for something like that on my own time.

I'm so sorry...... I know how painful it is. {{ hugs }}

prmenrs, RN · Sep 14, 2013

Sometimes we could go home, sometimes not. If the babe was really sick, and they had staffed for him/her, they might be overstaffed when the baby died, so you might be able to go home. However, it didn't always work that way. It might be someone else's "turn" to go home early, so you had to take their assignment.

Once, I was sitting w/the baby in the nurses station waiting for security to come and take the baby (w/me) to the morgue. The charge nurse took the baby out of my arms, and told me to go on transport w/another nurse for twins. I had worked 9 hrs already on the baby that had passed, I was useless on that transport. Don't think I had a brain cell left in my head!!

NicuGal, MSN, RN · Sep 27, 2013

I wish we could go home, but if it happens at the start of your shift or in the middle, you are kind of expected to "tidy up" and pick up a new assignment. We had one of our brand new nurses walk into a maelstrom and I told her to go home when it was all done. She was fried and I knew there was no way she could function after that. Got my tail feathers clipped for that decision because our matrix called for 17 and I took our numbers down. Whatever.

When we had our one pastor, he always made sure we had a debriefing, but the cut our clergy and we only get supervised students now. Sucks to suck as they say

Susie2310 · Oct 7, 2013

janfrn and prmenrs, you are both much stronger people than me. I can't imagine being able to do what you did.

Pediatric Critical Care Columnist · Oct 7, 2013

You would be surprised at what you're capable of when circumstances demand. With experience and longevity comes a sense of "how can I NOT?" that you aren't conscious of until after it's over. You do what your heart tells you is the right thing.

Bortaz, MSN, RN · Oct 11, 2013

You would be surprised at what you're capable of when circumstances demand. With experience and longevity comes a sense of "how can I NOT?" that you aren't conscious of until after it's over. You do what your heart tells you is the right thing.

This is the wisest thing I've ever read here. You're a special kind of heroine.

Pediatric Critical Care Columnist · Oct 11, 2013

This is the wisest thing I've ever read here. You're a special kind of heroine.

The night that I gave a baby that I knew was already gone fentanyl because his pacemaker was still pacing (we're not allowed to do anything with them other than verify settings - our doc being at a code on another unit) and his dad was sure he was in pain was perhaps not my finest moment. But I'd do it again. In a heartbeat.

Bortaz, MSN, RN · Oct 11, 2013

Not long out of orientation, I was working with another nurse on a 2-baby assignment. One was a sick 24 weeker on a jet vent (she was training me on the vent), and the other was a Trisomy 13, DNR. The trisomy had a heartbeat in the 40s, sats in the 20s, just lying in a radiant warmer, crying softly. Mother was unable to come to the hospital because she'd been held up at the border crossing.

While working with the preemie on the vent, I kept being distracted by the crying trisomy. It tugged and tugged at me, until I finally told my co-worker that I was going to take over full care of the T13 and leave her with the 24w.

I spent the next 9 hours caring for that baby. Swaddled her, sat in a rocker with her, sang to her and played music on my phone. She died in my arms about an hour before my shift ended. I simply couldn't let her lie over there, alone and crying, waiting to die.

Pediatric Critical Care Columnist · Oct 11, 2013

You totally get it... Sometimes being human means doing something you never, ever, thought you'd ever have the wherewithal to do. I feel it's absolutely vital that we support each other at these times so that we never lose sight of that kernel of humanity we all have within us.