Sobering first day on the job.....

[KckStrt]

this is a sad story about my first day as an ed rn.

little history.. i have been an rn since july 07. yes i am sure i look like a deer in headlights most of the time. but i did a short stint on a med/surg floor at large hospital in st. louis, and then my family and i relocated to atlanta.

i landed the job i wanted at an ed. wow... i was so excited to head to work and get the ball rolling. start taking my acls, pals, tncc.... i just couldn't wait.

well, the first day in the ed on the floor was wed, dec 26th. all the usual suspects coming through the door. my preceptor showing me around and trying to keep me involved. i tend to just jump in when i can, taking vs, asking some hx questions, hooking up ekg... just trying to be part of.

8hrs into my 12hr shift, call goes out over head "team a (my team) pediatric code to rm......" what arrives is absolutely heart breaking. a 2y old, cold water drowning......... we, i should say they, worked on this little guy for 50 minutes and finally stopped and let him go. i was absolutely blown away. i had to excuse myself to the rest room and get a grip on my emotions. i have never felt so sad for someone else in my life. i know it's not about me, but i just couldn't ignore what i was feeling fear and sadness, because i have a 2 year old at home. i was just devastated.... and on my first day!

some of us eventually talked about it and what we were feeling and thinking. the rn educator found me and wanted to discuss what i was thinking and feeling. i left that night and did cry on the way home, thinking of that poor baby and his family, what they must be feeling, what next christmas would be like, about them going home and seeing that babies toys from santa.... my god, i still become so upset when i think about them.

i know this will pass, i guess what i need is to know i am normal, that if i didn't feel this way something may be wrong with me. i also wanted to share this in hopes that another person may get something out of this story. i am still excited about heading to work in the morning, but i am very apprehensive i guess. i want to do a good job, i want to be of service to someone else for a change, but i also have to be able to experience my feelings and not just bury them.

[delvenia]

i am a nursing student and wish to also work as an RN in the emergency department when i graduate next year. the feelings that you had just confirms that you are human and that you have a good heart. i have heard from my mentor who has been a RN for 43 years, that you learn how to accept such tragedys as you chug along, but you should never lose your ability to empathize. i wish you well and just pray for the family....

[Larry77, RN]

There are special cases that you will never forget and it sounds like this child will be one of them.

If and when you can lose a child in a trauma or code and are not emotionally affected it is time to retire.

Your post made me think about a 3 year old we lost a couple weeks ago d/t head trauma--there was not a dry eye in the room once we called the code. You have to hold it together while you are working on them but when there is nothing left to do, you get to cry, hug your coworkers, and go home and hug your kids.

[JustaGypsy]

Hi Steve. First, let me say I am so sorry you had to witness this on your first day!!! It's hard enough, even once you are "seasoned."

I, too, am an ER nurse, it's all I've ever done, having graduated in 1999. In the last 2 years, I have been the primary nurse for 4 pediatric deaths and 3 full arrest reversals. Three of the deaths were all within about 9 months, and it was awful. For one of them, the ambulance corps that brought the patient hosted a grief/crisis intervention, which I attended. One of the deaths was my DH's bosses grandson... who is also a friend. One of the things I learned in that session is that it is not unusual for the caregiver to experience such grief that they often go into a period of doing things that are completely uncharacteristic for them in an effort to cope. They basically "cope" without ever really coming to terms with what happened, or feel that they themselves failed due to the child's death.

All I can tell you is to make sure you take care of yourself!!! Talk to someone about what you are feeling! Talk, talk, and talk some more! DO NOT feel that you should be able to "suck it up," or that you will never be able to be a good ER nurse because this incident affected you so profoundly.

No one person is responsible for this child's death, least of all the medical staff that tried to save this child. Children are NOT "little adults." When they crash, they crash hard. And although they have an amazing capacity to recover from such a profound injury, getting them back is the hardest part. And sometimes they don't recover.

The 3 deaths in the 9 months were awful; the oldest 18 months, one smothering, and 2 SIDS. I spent many hours within those 3 cases hugging Moms and Dads, telling them it was NOT their fault. One of the babies I even carried in a baby blanket to the morgue because I simply couldn't zip another baby in that white bag. Someone stopped me in the hall on my way down, wondering whose baby I had and wanting to see him... It was about 6 months after that until I felt that I wasn't "the keeper of other people's dead babies." And, yes, I cried with each and every one of those families.

In the time since, I have found I am really good at taking care of sick kids and their families. I have had families of these people come up to me in stores and other public places, not forgeting me. I had one of the children's siblings run up to me in the mall and hug me, not saying a word before doing this. This boy then looked at his friend's mom, who ran up after him and very wary of me, and said "This is the lady who made sure my brother was ok when he couldn't come home from the hospital," then simply walked away. The ER is great, but sometimes it is hard, chilling, and taxing to your psyche.

Bad things are gonna happen to good people. They will appreciate having someone who can identify and acknowledge their grief, and support them as best you can thru it.

[canoehead, BSN, RN]

This boy then looked at his friend's mom, who ran up after him and very wary of me, and said "This is the lady who made sure my brother was ok when he couldn't come home from the hospital," then simply walked away.

See now, THAT is what nurses can do. We are priceless.:balloons:

[911RN]

I'm sorry that this happened on your first day. It does happen, something you never get used to. SIDS, drownings, MVC's, child abuse.

Please know that everything was done to save this child. Every ER nurse and Dr can tell you the story of their first pedi death. It never gets any easier, sorry to say.

You will see the worst of the worst in the ED. You will also see the miraculous saves. You save the ones that you can.

I had a child abuse case this week, child w/ a skull fracture from Mom's boyfriend. Yes, I cried on the way home.

[Mobeeb, RN]

Well, I've been working in a busy ED of Level 1 Trauma Center for 21 years, and I still cry, so...yes, what you are experiencing is normal. The day you stop caring is the day you need to get out of this business. Bless your heart.

[Blee O'Myacin, BSN, RN]

That's just horrible. Pedi codes are never, ever easy - and on your first day too. I am so glad that your educator sought you out and talked to you. Especially since you are so brand new and haven't yet developed that bond with your coworkers yet.

By all means, take time to process this. But get right back in there. We need you.

((Hugs))

Blee

[SteveNNP, MSN, NP]

I can't add much to what the others have said. You are a human being, and as a nurse you are witness to the births, deaths, highs and lows of humanity. I've worked peds/neonatal since graduation, and I still choke up when I have a child pass away. I don't have any children of my own, but I rest at night knowing I did everything in my power to save that child as if it were my own. Pediatric traumas, abuse, etc are always heartbreaking. As nurses we get to experience something that not many people ever get to experience. Stay strong, remember to acknowledge your own feelings, take time to decompress, and know that what you are doing is making a difference in a family's life.

[flightnurse2b, LPN]

i don't have much to add, all the PP's are right on with the advice they gave you. i have 6 years of pre-hospital and ER experience, and pedi/neonate codes never get easier. i posted about my first pedi code here because i never, ever forgot her or any of the details surrounding that day...almost 5 years ago. that baby's death almost made me leave the medical field entirely... i was so, so sad about it. but i found that talking to my coworkers, journaling, and crying..ALOT... really helped.

i think the main emotion i felt was anger. i was mad at everyone for what happened to her. i was mad at god. her parents failed her, the legal system failed her, and i felt like i failed her. i realized after this that i needed to remember i wasnt a robot. i was still a human being under my paramedic superhero mask. i couldnt be expected to fully understand why her life was so brief, but i could figure out how i could cope with it when a similar situation would arise (and it has).

the ER is one of the most rewarding as well as the most difficult places to work. you will have days like this, and you will have days when you will witness miracles. and at the end of a long, physically exhausting and mentally trying day, you clock out only to come back for more. i agree with the PP, the day you stop caring, is the day to give up nursing. dont bury your feelings, experience them as they come, and learn what works for you.. i personally sing when i'm having a rough night...keeps my mind busy.

cry if you need to. grieve. look to your coworkers (or to us!) for support. journaling or blogging helps alot too. take a long walk or bath. relax and take care of you. spend time with your kids.

god bless!!:icon_hug::icon_hug:

[bill4745, RN]

Three weeks into my ER job, a 9 month suffocation came in, blue, tubed, and flat line. We worked on her for 45 minutes. For the rest of the day, they were a lot of otherwise strong docs, techs, clerks and nurses with tears in there eyes.

If you don't cry once in a while you are in the wrong profession.

[Sabby_NC]

Bless your heart what a tragedy.

It is hard anytime to lose a little one but at this time of the year is even harder.

Thank you for being there and thank you for having such feeling.

Nursing allows us to see a lot of things we would never see but there is a down side too such as yours.

Learn from every experience you see, yes even this little boy would have taught you something. One has to look deeper at times.

You will do fine in the ED. :)