The 1st Time You Cried on the Job

[Eilana]

Yesterday, I did something that I didn't think I would do on the floor: One minute I was just laughing and cracking jokes and the next thing I knew I started crying in front of my instructor. There were only the two of us at the time and she kindly gave me a few tissues and just let me cry it out. I didn't know what came over me! Anyways, I'm sure each nurse has gone through this experience. My question is how do you cope with your loss, pain, depression, despair, anxiety? How does your own coping process influence the nurse-client relationship?

[LoveTheNICU]

I had worked as a CNA and tech for many years, specializing in Alzheimer's care, and therefore I witnessed the end of many people's lives. Some went peacefully, other not so quietly, but through it all I never cried.

However, this previous summer I began working as a nurse extern in NICU, the unit on which I now am beginning employment as an RN. I saw many tiny, fragile, sick children, but even in crisis, managed to hold it together... until one horrible day. We had a baby girl, born outside the medical center at a tiny rural hospital. Her mother's labor had been progressing normally, until her water broke and she developed a prolapsed cord. Instead of doing what I was always instructed (as was every other nurse I've ever asked) and using a sterile, gloved hand to push the baby's head off the cord, the resident on duty allowed the mother to continue to push until an operating room became available for a C-section- they had only one in the hospital.

The baby's Apgars were 1,1 and 4, but finally they stablized her enough for transport. Upon arriving to us, she was seizing nearly continuously. The EEG showed brain death, a result of prolonged hypoxia. I was hit so hard by this beautiful, perfect looking term baby in a room of 24-26 weekers- essentially fetuses. She simply looked peacefully asleep, not "sick" like the others. She remained on life support for a few days, until the mother was well enough to be transferred to us, and the family finally made the decision to let her go.

This was my first experience with discontinuing life support. In our unit, we disconnect the baby from all monitors and the vent, take them into the private family room and then continue to bag them manually until the family is ready to say goodbye. Then, the ET tube is pulled and the family holds their angel as they leave the earth. For many, it is the first time they have seen their baby's face with no tape and tubes protruding from it. I was holding myself together until the moment the parents finally told us to quit bagging her- but as the nurse pulled the ET tube, and both parents bawled uncontrollably, I could no longer help myself. Tears poured down my face, and I excused myself from the room on some errand. Once in the hallway, I began to sob, but eventually pulled myself together enough to continue do everything I could for this family. I cannot imagine the pain of losing a child in this manner- especially knowing that if proper protocols had been followed, this may never have happened. I do not know what happened with the family after that day- whether they ever sued the original hospital or physician. Although I admit medical lawsuits are getting out of hand, I absolutely hope they did, and won... While nothing can replace their loss, the care of that delivery was unbelievably inadequate.

So many people are replying to this thread, saying that they could never be pedi nurses because of the pain of losing children. It is important to remember that for every death I have experienced, there have been at least 10 happy, healthy families I have managed to send out the door with a bundle of joy. In NICU, the bad days are awful, but the joys are many, and it keeps us coming back each day.

[bopps]

I always cry when a kid dies. The first time I cried in the job would have been during a traumatic code. This fourteen year old girl had been out walking and had gotten hit by a car. We worked her a long time......the Doc. officially called it but said to keep bagging her and doing chest compressions untill the family came in so they could see that we did everything possible. I was doing chest compressions and holding myself together untill the mom walked in the room. The horribleness of what had happened sunk in and I started to quietly cry as I was pumping on this poor girls chest. I left as soon as possible and went into the breakroom and collected myself. I was really upset, and then I realized it was almost an exact year to the date that one of my friends younger sisters had died in a freak accident. Hard, too many memories

[Little Panda RN, ASN, RN]

I came on at 11pm and had a patient who was on a ventilator and braindead. He was 19years old and had hung himself. He was living with an older brother and was attending the local community collge. His brother came home and found him hanging. He called 911, and they got a faint pulse and put him on a vent in our unit. My report was that the family was waiting for an uncle to arrive and then he would be terminally extubated. Orders were already written for morphine and to d/c vent when family requested. An hour the uncle got there and I gave an IVP dose of Morphine and d/c'd the vent. About 10 people were in the room, all crying. I was okay at this point, thinking the usual things, "how awful, what a waste, what a handsome young man...etc." It only took about 5 minutes for him to die, and the visitors left. The mother came out and asked if it was possible if she could get into bed with him and hold him one last time. I shook my head yes and grabbed a fellow nurse and we changed his bed, cleaned him up and moved him to the side in bed. I opened the door and the mother came in crying. She got into bed with him and held him and whispered how much she loved him, etc. It was then that a fellow coworker told me that the mother had just lost another son 2 years before in an MVA. The parents were local chapter leaders of the Greiving Parents (something along those lines.) As she climbed into bed with him I started to cry silently and moved out of the room. I went straight into the employee bathroom and cried for 20 minutes. I came out and the mother came up to me and gave me a hug. She thanked me for my "work and understanding. She appreciated the emotion from me and said her son would have liked me."

I still cry when I think of it. It was and still remains the most emotional work day of my life.

As a nurse, we see a lot of sad situations. We have to find comfort in knowing that we are helping somehow. I helped his mother have her last moments with her son whom couldn't be saved by medicine or surgery. For this I am grateful to be a nurse.

words can not convey the emotions this story evokes.

[nightingale, RN]

The first time I cried, as a Nurse, I was in the Med Room. I was so behind, at the time, it was so much pressure. I also remember crying while giving report when I was talking about one of my, in Hospital, Hospice Pts.; I just started gushing and I could not stop...

Ya gotta find support, friends / colleagues, to talk with about your day. I am on one of those business retreats this weekend. I am with a collegue who was a good friend and study buddy in school; we have talked until our voices were sore! Boy... do I feel better!

[nan1993]

The first of many cries happened about a year after I graduated. I was pregnant with my second child (who is now seventeen). I was pulled to the PICU to help with a "harvest" (organ donation).

Everything was fine until I touched the little girl, she was the same age as my five year old (who is now twentytwo). She and her siblings were left with a twelve year old baby sitter, who drop ashes from her cigarrette onto the Christmas tree. There was a big fire, one was burned with third degree burns and died, another died on arrival at another hospital. When I held her hand, with nail polish on her little fingers, I cried. Her hands reminded me of my daughters. I could not leave the bedside. The mother finally came, she had been out drinking with her boyfriend.

After that I was pulled for four hours to the ER, and had a patient with a gun screaming demands. I feared for my life, and my baby. Security came and restrained him. By the way, security could carry guns back then. Any way I cried all the way home and for a few more days. You will have days that you cry, but you will have good days too.

[LoriAlabamaRN]

My first "real" job as a nurse was at a physical rehab center. There was this wonderful fellow RN who was more than a preceptor, she was a mentor and a friend to me. Then one horrible rainy Monday I came in to see her name on the report sheet- as a patient. She had had a stroke at age 44, was hemiplegic and mentally disoriented. I sat with her all shift, praying as she patted my face with her "good" hand. She wanted me to write out simple med calculations, which she could not begin to do. That day I locked myself in the restroom and cried for a long time. More tears came as her condition deteriorated, and as the cause of the stroke was finally found- terminal cancer, of the liver, brain, and bone. She died within weeks.

This one's for you, Sandy. Still the greatest nurse I've ever known.