RNs...how did you handle your first death ?

leslie :-D · Sep 28, 2008

As a Hospice nurse, I can tell you some are easier than others. I find the most difficult ones are the ones that are really young or really tormented. Most times, they have lived long and happy lives. But to watch someone who has been a mean and nasty person their whole life try to come to terms with the choices they made at end of life can be a form of hell on earth.

shay, you work inpatient, yes?

my goodness...the stuff we see.

and if there's one thing i've learned about dying, is i had better make the most of my living.

because there is nothing worse than witnessing the mental torment of an anguished pt 'knowing' that he's doomed for hell.

i can't emphasize enough, that mental/emotional pain needs to be addressed as much as the physical.

anyways...

my first pt in an inpt hospice facility...

a woman of faith all her life, yet became highly anxious at the end.

in spite of mega doses of meds and all sorts of supplemental therapies, it seemed she was fated for a distraught transition...

until her husband came to her (who had already died)...

her eyes became clear, color returned to her face as she excitedly told me "he came for me".

me, in my green naivete, shared in her excitement, just as amazed and entranced.

it was then i could truly look in her eyes and tell her, "see? it really is going to be ok. now go along and dance with your husband".

she quietly closed her eyes, holding onto my hand, and contentedly died within 15 minutes.

from that very first experience, i have embraced and encouraged all 'company' who come to take our loved ones home.

so even in the most tormented of deaths, i 'know', it's all good...

and death is the release where our spirits will soar.

leslie

locolorenzo22, BSN, RN · Sep 28, 2008

I tend to view death as a release from our time here. Often, if it's someone who has been struggling or it's expected, I find that I will be sad for the person, and while cleaning them up will still talk to them or sing, etc.

It's tough when it's someone in the prime of life, who through a bad choice or event winds up on death's door. My first few weeks in the hospital, I had a 34 yo male with a gunshot wound....through his chest. he was stable enough to be out of ICU, but they didn't know if he'd make it. 50/50 chance. I had him one night. Checked in on him and family, cleaned him, family would help me turn, etc. When I came back that night, he had passed....and the thing that got me was that the family told the day nurse to make sure to tell me that "he did a fine job with x. We have never slept as well, knowing that he would be back at least once every hour. Tell him that he passed peacefully, and well taken care of." THAT made me cry for 10 minutes before I clocked in.

Vito Andolini · Sep 28, 2008

It was very spooky. I feared demons and the devil, had nightmares for a couple of weeks off and on, thought how sad and scary it all was.

Death is part of life but it's still never easy. It is often preceeded by serious, prolonged suffering and it brings such misery for surviving loved ones, squabbles over estates, loneliness and anguish, suffering for those who care for the dying, especially babies, children, people who are alone.

You'll do ok, though. We all make the adjustments.

KdnRN2B · Sep 28, 2008

I was also somewhat afraid of this, because I remember being in school and crying like a baby while watching ER. But it never turned out to be an issue. Most of the deaths I have seen have been in an adult ICU setting, and almost all are advanced in age and have lead long lives and have been suffering with illness and honestly many times death can come as a relief in these cases. Its hard to explain, but for me(who is pretty emotional and cries watching movies all the time) its like I get into this professional mode at work and it doesn't get to me as much. Its like I know that these families need me to be sturdy and professional and supportive and the emotional switch in my brain just gets turned off without even trying. Do want to add that I have seen nurses cry with family when some passes and I consider it professional as well, it just rarely happens to me at work.
There is one time I remember getting in my car and crying on the way home, because we had this woman in her 40's who declined very quickly and was brain dead. Her husband came in every morning at 5am and was so pleasant and warm to the staff and so dedicated to her. He gave her almost a week and when he was convinced there was no way she was ever going to improve, he came in that morning and we had a long talk and we called the docs that am before I left to have arrangements made for her to be taken off life support. He said he loved her more than anything, and he loved her so much that he felt that it was selfish of him to keep her alive like she was and that she would not want to live that way and he was going to do what was right by her. And Oh man it just broke my heart. I was SO glad that the dayshift was the one that took her off and watched her pass, because in that case for whatever reason, I would not have been holding it together as well. I cried as soon as I got in my car to go home.It just hit a nerve. But its funny because I have seen some situations that are much worse, just this one always stuck with me.
Will say though that I dont know how I would react in pediatrics or in NICU or something..........adults can be hard enough:nurse:

awww...so sad...I want to work in NICU when I graduate I hope I can hold it together :cry:

patwil73 · Sep 29, 2008

I have been the nursing leader on our code team for the last 2.5 years. Before that I have worked ICU and hospice, so I have seen my fair share of deaths. They have run the gamut from babies to the 101 yr old family wanted everything done for. I tend to empathize differently with each one.

I think the ones who get to me the most are the crying families who just beg for us to do something, anything to bring their family member back. I have literally performed CPR with tears running down as I attempt to convince them that they are not coming back.

Showing some emotion can be very helpful to a family in these times. They know that someone truly cares. However we should remember that it truly is about the family at this time. I have run codes I knew were hopeless from the start that gave the family time to see what heroic measures really mean and allowed them the opportunity to make the decision to end it. In most cases it ends sooner than we would have done so.

How I handle death is to go home, hold my wife and kids and enjoy the life we have. I often cry which truly helps. Then I go back to work the next day and do it again, realizing we do help save more than we ever lose.

Hope this helps

Pat

Diahni · Sep 29, 2008

hey guys, im kind of curious...how did you handle your first patient dieing...im a student nurse and im kinda worried about how i would act to my first death :uhoh21:....i think i will probally start crying so i wanted to ask my wonderful nurses out there how did you handle it ? what was your experience ?

kdn,

hey, you might surprise yourself. as a student, one of the first patients who died was an amazing person, and i liked him very much. i found his death, however, to be very different than if he had been a person in my personal life. if you do have a hard time, however, emotional distance is a skill and it can be learned. if you can't learn it, stay in a specialty where you don't have to deal with it, or you'll be miserable. it comes down to knowing yourself. i have a hard time with kids in pain, but not so much adults, and so on. as a student, you'll find out fast!

diahni

finn11707 · Oct 2, 2008

My first death was my sister who died at age 17 following a car accident. I was 16 and in a haze for many months after that.

My first few months as a new nurse, I cared for a woman with cancer who came into the hospital for pain relief. I grew close to her. She seemed so at peace and wise! I still see her face clearly in my mind's eye. I think she knew I was afraid to face her death. The night she died, she called me into her room just before the change of shift, asking for pain med. When I brought it to her she asked me to sit and talk. She thanked me for my kindness to her and for not hurrying out of the room each time I came in to do something. I found out the next day that she died as I left my shift that night. I was sad, yet relieved, and ashamed, I had not been with her when she died.

The first patient who I was present with as he died was 5 years after I became a nurse. I was working ICU in the hospital where this prominent patient served on the hospital's foundation board. He had an unstable night following a big MI and began coding when we were still in report. We coded him repeatedly through my shift as he extended the MI. Each time, he begged for us to not let him die. The doctor leading the codes was his good friend and stayed in ICU all day. When his friend called final code off, I said "goodbye C---". He turned his gaze on me and left his body. I cried.