...to shake a new nurse's self confidence. I watched my patient die before my eyes tonight. 89yo LOL, DNR, admitted for CP, totally alert and oriented. 2 hours after admission, suddenly says she "can't breathe". Desatting, despite increasing O2 flow rate until she is on NRB flush. By the time the RRT showed up, she's already satting in the 30s, HR in the 20s. It was so sudden and fast, we should all be so lucky. I think she threw a PE.
It was her time to go, and I did everything right, but still.....I question myself. What could I have done differently? Did I wait too long to get help? Did I miss something that I should have noticed? My head knows I did a good job, but my stomach is in a knot and I keep doubting myself.
The CNA was awesome. She stayed with the pt. the whole time, while I went and got meds, made phone calls, grabbed masks. She left before I had a chance to thank her. :redpinkhe
Ok, so this may be a stupid question. Forgive me, I am new and have not experienced a patient's death.
But, if the patient was a DNR, why did you call rapid response? Is this just a standard protocol in your facility? What would they have done considering the patient's DNR status?
A few years ago, my 80 year old Aunt with well controlled CHF, woke her husband (my Uncle) up at 6am and said "I'M Dying". he quick dialled 911 but she was dead by the time he hung up. My guess is some kind of rapid onset pulmonary edema. Even tho she was 80, everyone was taken by surprise. But not a bad way to go, actually.
Sudden deaths happen. She was lucky to have you at her side at the end.:heartbeat
Wow. She told it like it was.
To the OP, well done! You helped her make the transition when it was her time to go. It was a better death than getting transfered to the ICU and spending a week on a vent...
Ok, so this may be a stupid question. Forgive me, I am new and have not experienced a patient's death.
But, if the patient was a DNR, why did you call rapid response? Is this just a standard protocol in your facility? What would they have done considering the patient's DNR status?
DNR just means no paddles, I think. Not other interventions.
i experienced the death of a patient only a couple of days ago ...i am still questioning myself and not coping well emotionally . My patient was a DNR, 87. Sweet lady with dementia and I had talked with her family several times through the stay and connected with them . I had medicated her for pain , and later in the night with xanax for agitation . i had checked on her an hour earlier , and she had been asleep , woke up briefly when i came into the room , and went back to sleep . When i went back in an hour later , she was gasping for air , and not arousable by sternal rub . I called for help,called for rapid response ..called the MD ..and he said do nothing . I felt so helpless . I am not a new nurse , but this was my first "unexpected " death .Unexpected as in not a hospice patient , or someone you get report on , and you expect it. I know at 87 death should be probably be expected . But it does not make it any easier .
I am glad the family made it in time to be by her , before she died . They said "we have been expecting this for a long time" . After she died , I noticed her legs blown up like balloons with edema. Pulm edema, did she throw a PE ? Did I overmedicate her ? could I have done anything differently ?. .....i am finding myself on my knees , praying , looking for answers and the strength to go back to work.
i experienced the death of a patient only a couple of days ago ...i am still questioning myself and not coping well emotionally . My patient was a DNR, 87. Sweet lady with dementia and I had talked with her family several times through the stay and connected with them . I had medicated her for pain , and later in the night with xanax for agitation . i had checked on her an hour earlier , and she had been asleep , woke up briefly when i came into the room , and went back to sleep . When i went back in an hour later , she was gasping for air , and not arousable by sternal rub . I called for help,called for rapid response ..called the MD ..and he said do nothing . I felt so helpless . I am not a new nurse , but this was my first "unexpected " death .Unexpected as in not a hospice patient , or someone you get report on , and you expect it. I know at 87 death should be probably be expected . But it does not make it any easier .
I am glad the family made it in time to be by her , before she died . They said "we have been expecting this for a long time" . After she died , I noticed her legs blown up like balloons with edema. Pulm edema, did she throw a PE ? Did I overmedicate her ? could I have done anything differently ?. .....i am finding myself on my knees , praying , looking for answers and the strength to go back to work.
respectfully, your pt was 87.
believe me, it's a blessing when they die of old age, versus some painful, dragged out, disease process.
whatever happened, it was her time.
mourn her loss, and move on.
to need strength in returning to work...is a bit extreme, i think.
thank you for your input ...and expressing that my coping mechanisms or lack thereof ...are a "bit extreme" . I hope i never utter the words " mourn and move on " to anyone ....nurse , patient or family.
To the OP know you did everything you could have. The best gift you can give a dying patient (at least one who has lived their life and has decided that they do not want any more heroics) is to be with them and support them as they pass from this world.
.....i am finding myself on my knees , praying , looking for answers and the strength to go back to work.
thank you for your input ...and expressing that my coping mechanisms or lack thereof ...are a "bit extreme" . I hope i never utter the words " mourn and move on " to anyone ....nurse , patient or family.
Kiahni I think that what Leslie is trying to say is for you to recognize that dying is as natural process as being born, and we all will face it sometime in our own lives as no one lives forever - including ourselves. As nurses we need to recognize that at sometime a persons life has to come to an end and it does not have to be a devastating experience. Sure it is sad and the person will be missed, but if the death of someone who has had a full life has you wondering how you will find the strength to go back to work then it may be time for you to do some of your own soul searching as to your own reaction to death.
As nurses we are given the GIFT to be with the dying and to comfort and support them. We are able to allow them to die with dignity and to relieve their suffering as much as possible. Yes there are times when you will have patients die in agony or be very afraid - but even if you cannot relieve their physical suffering you can hold their hand and let them know they are not alone, and that you are doing everything you possibly can to make them comfortable.
It is not a bad thing to shed a few tears, debrief with coworkers or seek counseling if you need to, but to let it take over your life and emotions is taking it too far. I work in an inpatient hospice so all of my patients are dying, and I know Leslie also works in hospice so she has lots of experience as well. I personally always look at the obits in the paper to see who has died and I always read my patients obits so I can see what their lives were like before I knew them, it is one way I cope with all the deaths and personalize it, but I celebrate their lives and the memories they leave behind and am thankful that I was able to provide a bit of love and care for them in their final days.
Did I overmedicate her ? could I have done anything differently ?. .....i am finding myself on my knees , praying , looking for answers and the strength to go back to work.
Wow, you're going to drive yourself batty unless you find a way to strengthen your resolve. Death is inevitable, especially with an elderly patient. It's the natural order of things. And usually a blessing in disguise. If you don't find a way to desensitize, your mental stability will have a hard time surviving this profession.
TangoLima
225 Posts
Ok, so this may be a stupid question. Forgive me, I am new and have not experienced a patient's death.
But, if the patient was a DNR, why did you call rapid response? Is this just a standard protocol in your facility? What would they have done considering the patient's DNR status?