Shell Shocked

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Specializes in Trauma ICU, MICU,Tele. PCU, IMC.

My patient died a few nights ago. It was the most bizarre experience ever. I had just been in his room, taking his blood pressure (which was fine), drawing his AM labs and talking to him. I walked him to the bathroom and back, then tucked him in his bed, got him a warm blanket and said goodnight.

I went into my next patient's room to hook up his antibiotics. The Monitor tech calls me and tells me my other patient has a junctional rhythm. I rush in there and he's pale and unresponsive, his head crooked over to the side, his dentures halfway out of his mouth. I instantly freaked and started shaking him, then hit the code button (even though he was DNR). I told the other nurses that he was DNR with chemical intervention but his heart had stopped beating and he wasn't even breathing. The doctor pronounced him at a few minutes after 3am.

I'm still upset beyond belief. How can someone be talking to you and then dead the next minute? He was old, ...beyond that, he should have been fine. The family is not going to do an autopsy, so I'll never know what happened but always have questions.

This isn't the first time that my patient died, it's just the first time that it was so unexpected and random. I was the last person that he saw before he passed. I was the last person he spoke to. I was the last touch he had, the last voice he heard, the last smile he saw. I'm still shell shocked. The nurses on the unit accepted it cynically, just another day on the job; and almost without empathy. I'm dealing with hella emotions at this point, feeling that if I had stayed in the room for just a few more minutes I could have helped him live.

The next night I had a patient in the SAME ROOM. Unfortunately he didn't get much sleep that night because I kept going in to make sure he was still alive. I checked on him almost religiously, freakishly paranoid that this old guy would die on me too.

How do nurses deal with all these emotions? I don't know what to do.

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Specializes in Education, FP, LNC, Forensics, ED, OB.

It's hard, Spiderella. This happens and sometimes with absolutely no warning.

((((HUGS)))) to you........

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Specializes in ER, Occupational Health, Cardiology.

At least he SAW a smile from the last person to be with him and help him, AND the person who tucked him into bed with a nice warm blanket. You did your best, that is all you can do.

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Specializes in Geriatrics, Med-Surg..

I had something like this happen to me when I was a student. It took me quite a while to deal with it. The only good thing that came of it was that it got me doing some extra learning. Here's hoping you find some peace soon as I am sure you did all that you could.

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Specializes in Emergency & Trauma/Adult ICU.

{{{Hugs}}} to you ... it's very hard at first.

I took care of a patient who went from a fairly stable rhythm to coding literally right before my eyes. His family was at his bedside. The four of us were having a pleasant conversation and he had asked me to find out the score of the football game. Then, above his head, the monitor became v-tach and then v-fib. We did not get him back.

Your personal spiritual beliefs may help you with this.

And yes, I was spooked by that ER room for a few weeks afterward.

Take care.

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Specializes in ER, Infusion therapy, Oncology.

It is very hard when we lose a patient. Especially when they die suddenly. Even if you had been in the room when it happened it probably would have changed nothing. You said he was a DNR, and only a chemical code. In my experience chemical codes without CPR accomplish nothing. Take peace in the knowledge that you were with him in the last few minutes of his life and were able to bring him comfort. :icon_hug:

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Specializes in Med-Surg, , Home health, Education.

I used to second guess myself too when a patient suddenly slips away. One of the sweetest docs I used to work with said "I never take credit for saving a patient because if I did I would have to take credit when they died". I wish I had heard that many years before. I'm sure you'll "save" many so don't beat yourself up. Peace to you.

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I used to second guess myself too when a patient suddenly slips away. One of the sweetest docs I used to work with said "I never take credit for saving a patient because if I did I would have to take credit when they died". I wish I had heard that many years before. I'm sure you'll "save" many so don't beat yourself up. Peace to you.

Thanks for sharing that - this thread brought some tears to my eyes which I find don't flow like they used to because we have to learn to not show our emotions too much when patient's go bad

We've had sudden deaths on our floor (too many to want to count) and it's so shocking and sad for everyone. I liked the thought about remembering all those you will 'save' because we don't ever give ourselves enough credit.

I also still think of some 'rooms' as where some patient's died suddenly - eventually the memory fades with time

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Specializes in LTC, med-surg.

In my second year of nursing, working in LTC, I had a resident that was as feisty as they come, refusing care, refusing meds, name calling...

He started deteriorating after 2 TIA's, becoming incontinent of urine and stool. One afternoon he threw his poopy undies at the second shift nurse who reported off to me later that evening. His night went ok, a couple of "accidents, otherwise uneventful. On my last round at 6 am, he's lying in bed and crying "I don't know why I'm so being so difficult, I really don't mean to be" He also had some urinary incontinence again and was soo ashamed, couldn't stop crying. After washing him up and changing his bed I tucked him in and looked him in the eye and said: "It really is alright, we love you anyway" (This guy had no family). After that he stopped crying and gave me his big old smile and thanked me for my kindness.

Later that afternoon one of my co-workers called me at home and said "You won't believe who died today" They found him dead at 7 am with a smile on his face...

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In my second year of nursing, working in LTC, I had a resident that was as feisty as they come, refusing care, refusing meds, name calling...

He started deteriorating after 2 TIA's, becoming incontinent of urine and stool. One afternoon he threw his poopy undies at the second shift nurse who reported off to me later that evening. His night went ok, a couple of "accidents, otherwise uneventful. On my last round at 6 am, he's lying in bed and crying "I don't know why I'm so being so difficult, I really don't mean to be" He also had some urinary incontinence again and was soo ashamed, couldn't stop crying. After washing him up and changing his bed I tucked him in and looked him in the eye and said: "It really is alright, we love you anyway" (This guy had no family). After that he stopped crying and gave me his big old smile and thanked me for my kindness.

Later that afternoon one of my co-workers called me at home and said "You won't believe who died today" They found him dead at 7 am with a smile on his face...

What a sweet and sad story - ok, it must be hormones because I'm crying now.

No one except other nurses know how hard this job can be and what a difference we can make even on someones last day!

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Specializes in SICU, EMS, Home Health, School Nursing.

We had a patient that was very sick the other night, but we never expected him to code! The patient had been very rowdy all night long and suddenly he just started bradying and died. We coded him for about 30-40 minutes.

The worst codes for me are always the unexpected ones and the young people because you always tend to second guess your actions. Take comfort in knowing that you were there for him in his last moments here on earth. Not many people can say that they were there to comfort someone in their last moments. Also, take comfort in knowing that since he was a DNR, he knew his time was coming and was most likely ready to go. I deal with my emotions by talking about them, praying, listening to music, etc. You need to find what works for you.

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Specializes in Education and oncology.

This thread is why it's so nice to have this forum to share experiences that most lay people will never understand. I had a home care patient who had private duty nurses 24/7, and we got attached to her and her husband. He even gave the male nurses tickets to major games, and "entertained" us in their million dollar condo overlooking the SF bay and Golden Gate bridge. I had just walked the wife back from the bathroom when she died right in front of me and her husband. Her oncologist surmised that she had a massive PE, couldn't have been predicted or prevented. I was stunned and had to maintain something approaching professional and supportive. All arrangements had been made, but I was still shaking when I got home late at night. Be patient with yourself, I agree with other posters- at least your guy had a kind smile and gentle hands to tuck him in. I completely agree that if "only a chemical code", nothing done is better then drugs with no compressions. IMHO, you did the right thing. More hugs to you. :monkeydance:

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