Today was the first time i cried after a patient's death.

[estrogen]

46 y.o. IV drug user infected with botulism. Spent cca. a month at our facility, on a vent, completely paralyzed including his face, with 0 muscle tone. I'll admit that it took me a couple of days to realize that he is not in a coma, but all in there, with a completely clear mind.

Over the course of a couple weeks, he started getting a little better, started moving his right hand slightly and signal thumbs up, thumbs down as a means of communication and eventually with a lot of help he started writing on a note pad. I was excited, because unfortunately, we don't commonly see people getting better / overcomming their condition at out facility. I had high hopes and I honestly thaught, (it seems like most of the other nurses did too) that he will pull out of it.

Over the last few nights, he complained to me about being constipated and asked me to do a digital to get the poop out several times. He complained about pain and the feeling of fullness in his rectal area and an upset stomach (no vomit, no residual). His stool was pretty soft and formed. He had spontaneous BM's regularly, he just wasn't getting all of it out, so I did not suspect and impaction. One time he wrote on his pad "I'm suffering". I asked him if it's due to his rectal discomfort and he signed yes... I did another digital, gave him his scheduled methadone and ativan that he asked for and when I asked him, he stated relief.

The next day, I learned that he coded sometimes during the day, had a cardiac arrest, was resuscitated and sent to the hospital. The next day they called us that he died.

Maybe I didn't recognize the severity of his suffering, because he didn't have the usual means to express it. Maybe if I would have kown and sent him to the hospital, he would still be alive? Or maybe I was mistaken and he never had a chance.

He was a nice guy, just a year older than my husband. As far as I know, he was pretty much alone. He must have suffered a lot during the course of his disease. I wish I knew what's going to happen. I would have sat with him through the night, I would have held his hand, said more kind things.

[Bipley]

I'm so sorry. Sadly there is nothing I can say that will help ease your pain. But what I can do is send you mega cyber ((((HUGS))))

You are a very caring nurse. He was lucky to have you caring for him, never ever forget that. You know, we do what we can. We do every bloody thing we can.

On MASH years ago one person said to another that in command school he was taught two rules. Rule #1 is that people die, rule #2 doctors can't change rule #1.

Isn't that true for all of medicine?

[Nurseboy1]

((((Hugs))))

Very sorry you had to deal with this difficult situation. At least he had the knowledge that you and the other members of your facility cared about him.

[StuNurseUP]

I'm sorry for your pain. It would be wonderful if we could know ahead of time when someone is about to die; everyone would do things differently. Your patients are blessed to have a nurse like you that really cares about them.

Your patient wasn't alone, we never really are. God Bless you.

[Super_RN, BSN, RN]

i am sorry to hear of your pain :kiss

death is something that can't be avoided in our profression and although sometimes it is welcomed, it is still difficult to deal with. younger deaths always seem harder to deal with. he wasn't alone, he was aware of the amount of caring he received while under your care. remember that.

he was blessed to have someone as caring and attentive as you.

super

[Cute_CNA, CNA]

I am VERY sorry to hear that. I hope he is no longer in pain.