I admit as a new ED nurse, I definately have that rush when the EMS call comes over the radio that they are a few minutes out with a good trauma, but one recent call is more than I know how to let go of.
Im not going to go into a lot of details about the incident, but there was a 25 year old kid who was involved with a freak accident with a cement mixer. Needless to say, he did not survive. This was one of those cases where death was so much more merciful than survival would have been, and my saddness and grief are not so much related to his death, but I cant stop thinking about the absolute terror that this poor kid must have felt in the last few seconds of his life. It nearly brings me to tears when I do think about it.
So my question is this; when you have that patient whose story just rips your heart out, how have you dealt with it? How do you learn to let go of the hard cases so you can move on to help the next person who walks through the door? During nursing school, it was always a joke with my clinical group that if there was a trauma somewhere, I was probably near by and standing in the middle of it trying to help. I love what I do, and I honestly feel that the ED is where I am meant to be, but for the past week I havent been able to stop thinking about this patient. I actually had to choke back tears today when I started thinking about it.
I am sorry to hear you are having a hard time. I know this probably won't help you in this particular case but maybe with future patients. I have a particular way of dealing with my patients that are on the brink of death or have passed away. I treat the patient as if they were my family but I never think of them as family. I never think, "oh, what if that was my Dad" or anything along those lines. I have to remember I am there to help them and I do that by not thinking of their last moments alive, instead I focus on what I can do to help them. If I can't do anything more to help then I know I did all I could.
I agree with what flyingscot has said, especially the last part. The difficult times are what truly define us as nurses while holding onto our humanity inside of ourselves. You will never forget what you have experienced, but in time you will think of it with less pain and eventually add the results of your grief to your experiences and look back and see how it has shaped you both as a person and as a nurse. But right now, let it out, seek help, talk to a mentor or a counselor. You do need to deal with this. It didn't get easier for me, just different.
You did the right thing by posting here! You need to talk about this. Maybe you do need to cry, we all get choked up by something tragic. We're nurses and we're strong people but we're human too. I've been a nurse for 22 years and like you there's one tragic thing that always sticks out in my mind. The entire staff of the ER that night got a counseling session because we were all so shook up. When you have time, on an off day just let yourself grieve about this patient.
WOW! I am so thankful for the many replies I have received from this post. The support and different perspectives offered have been amazing. I have t o honestly say that the simple act of posting how I felt about this and reading all the responses has helped greatly. (Okay, plus a 10 day vacation on the beach...:-)
I have to say that although the case is still sad, I certainly feel as though I've been able to move on and continue to care for my patients and their families in a caring and effective manner.
Thanks so much for the support you are all wonderful!
I can understand and relate. I give myself time on my ride home (about 40 minutes) to decompress and think about it and cry, if need be. You can't change the fact that he died and the "what if" thoughts you have about his last moments, or the family's grief and their anguish is something that you have to put out of your head, for your own survival. I think there is lateral trauma, with being near and in the trenches of their situation, but remember you are there to help. You are not IN it. You were not IN it. You have to remember you did your best, now you need to shake it off and move on. You learned, you helped, and you cannot change circumstances. It's mental torture, and I believe PTSD, to keep going over it. I use some pretty rough humor and lots of TV watching at home. Love Eastbound and Down, True Blood, Jimmy Fallon... basically lots of gratuitious sex, drugs, etc. (on TV!!!) to shake me out of my funk. Good luck. We're all on that same road at some point. I can share some stories w/ you, if you want to PM me. It's good to vent on here too. Nice to know your sisters/brothers in arms share the same stories/situations to help debrief.
There are going to be those events in your career that will affect you profoundly. I have three. I remember every single detail of what happened. Sometimes the memories pop up at the most inconvenient times. I can tell you though that even though the memories remain, the powerful emotions that go along with them really do fade. At some point in time you will be able to think about the situation and your gut won't clench. You will become more objective and less emotional. I think these memories are important to hold on to. They are what shaped me as a nurse.
Same for me. Sometimes they pop up in my head and I turn on the radio, call someone to distract myself, or turn on the boob tube. Anything to distract my brain from rehashing it. There's nothing that can be done to be OCD over events after you've already evaluated your part and the situation. Time to move on and be ready for the next thing. We're in the ER for a reason. We're no good to ourselves, each other, or the patients if we can't move up and on in a reasonable period of time.
I work LTC so I don't get the traumatic deaths. But some of the residents deaths do affect me. One that happend a couple years ago still "haunts" me. Full code elderly man..went unresponsive, no pulse no breathing. I started CPR and continued awaiting the EMS to arrive. Doing CPR on a 90+ yr old person is traumatic enough in my opinion, but as i was doing compressions I glanced up for a second only to meet the eyes of his wife of 75 years. It was the time she always came in to visit. The look on her face still haunts me from time to time.
The one that stuck with me for a long time and still bothers me(probably would have done well with some sort of "therapy" or group support) was 15 years ago. I was working as an EMT when we responded to an "OD" call . I was doing the ambu-bag as the EMT-P was giving meds and doing his thing. Her eyes were open and somewhat looking to the left but no life in them. I followed what appeared to be the last place she was looking before she stopped breathing..and I saw a picture of her with her young child. The man who placed the call when he found her unresponsive and had started CPR was explaining that she had been a drug addict (herion) but she had been clean and sober for the last year, was working at a good job for about 9 months and was trying to save money to get a place of her own so she could regain custody of the child. I don't know the specifics but the father of the child was killed in a car accident but it was relayed that both he AND her child had died. She lost it and ended up going on a binge with cocaine for what they think was a day or so. She went on that binge thinking her only reason for being clean and sober and alive was gone..now she's gone and her child is parent-less...the look on her face, the way her eyes were "staring" at the picture, the picture of that beautiful baby..all of it still comes back to me sometimes in dreams, randomly during the day at times...but the intensity of the emotions is not the same as it was..As the previous poster said, that gut-wrenching feeling does go away. You will remember every little detail but the emotions you felt will not be the same over time.
I send you a big hug and thoughts and prayers. You will get through this, you might always remember "that one" but it does get easier as time passes.
I personally experienced one of these cases last night. It tore me up emotionally. I'm a new nurse. Graduated nursing school May 2014. I knew the moment that I was in clinical and got to work my first trauma that the ER was my nitch. I absolutely love my job but sometimes the overwhelming responsibility and trying to deal with the emotions of it all just completely overwhelms me. I'm still trying to learn how to deal with all of the emotions and I just want to feel like I know I poured my heart into that case and that I did everything I could and everything that I knew how to do to attempt to save that patients life and to be at peace with it. It's just so hard sometimes.
It probably didn't help that my work load got upped this weekend. For the first time I was assigned to triage and also got assigned to the critical patient rooms. I know that I'm ready for that as a nurse and I did a good job and took care of my patients to the best of my ability. But that extra pressure on top of the really difficult emotional trauma case were a little much this weekend.
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I am sorry to hear you are having a hard time. I know this probably won't help you in this particular case but maybe with future patients. I have a particular way of dealing with my patients that are on the brink of death or have passed away. I treat the patient as if they were my family but I never think of them as family. I never think, "oh, what if that was my Dad" or anything along those lines. I have to remember I am there to help them and I do that by not thinking of their last moments alive, instead I focus on what I can do to help them. If I can't do anything more to help then I know I did all I could.