Was I doing my job, or was I too attached?

[Megsd, BSN, RN]

I've worked as a home health aide in a retirement community since last fall and deal with people in all conditions, from bedridden to completely independent. Most of the patients, especially the ones who are already ill when I meet them, I don't get too close to because, deep down, I know their time is limited. But the independent ones are more difficult to distance myself from.

Since last October I have worked with an elegant, charming woman, J. I started out spending 2 hours a week with her to help her read her mail (she has glaucoma) and take her to the grocery store. She and I hit it off right away and she trusted me with every aspect of her life and care. In January she had a series of dizzy spells that resulted in daily ADL assistance. 4-6 days a week I provided her care, and I still spent extra time with her to go to the grocery store. I was her strongest advocate. I pushed to alleviate her concerns, to get her voice heard and to make her as comfortable as possible.

At the end of May, J had a stroke. I was the one who found her in bed, feeling ill, I was the one who called the medics since she had one-sided weakness and slurred speech. I was the one who gave her medical history to the medics.

After a stay in the hospital, J wound up in the rehab unit. She was in decent shape, but was unable to stand or walk on her own. She really wanted to go back to her independent apartment, but I had a feeling this wasn't going to happen. I met with her weekly to assure her that she'd be taken care of, to encourage her to continue her therapy. I kept in touch with her aides, nurses and social worker to make sure she was receiving the best care possible. When her only family came into town I was their liaison. The last time I spoke to her, they had decided to move her to assisted living, and I promised to take her for a tour of the building in the coming weeks so she could see where she would be living, and assured her that she would be fine there.

Last Tuesday the aides found her unresponsive and sent her to the hospital. She suffered a large hemmoragic stroke and was placed on a ventilator. On Friday her family decided that she would not want to be on a ventilator (I agree), and took her off it. She died later that day.

I did not know until yesterday she had even been hospitalized again or that she had passed away. The social worker came up to me and thanked me for all the things I had done for J and said I was a very important part of her life. And then she told me that J had died.

I couldn't help it. I teared up. I had other patients to see, though, so I kept my composure and finished my day at work. I was really fine until I started to go to sleep and began to process what I had learned that day. Her death was so unexpected that it made it harder to deal with than the other deaths I have faced so far. My boyfriend (a paramedic) noticed my tears and when I told him I was sad my patient had died, reprimanded me, reminding me that I can't get attached and I'm just going to have to learn how to deal with this or I will have a miserable career. Today I'm okay.. a bit blue, seeing her name on the list of "losses", but able to see my patients with a smile on my face.

I think I am dealing with it, but I don't think there's anything wrong with a few tears to process the loss and say goodbye. I don't think this means I was too attached, just that I was devoted to the welfare of my patient. I worked hard for her, and I will miss her company dearly.

Was my reaction to her death out of line? Am I doomed to a miserable career?

[FNimuaeMae]

Hey, you didn't do anything wrong. There is nothing wrong with being a good patient advocate and doing what you were doing. I had a patient last week that they took off the vent after a hard fought struggle to get her better and I cried. I was more upset after all that the husband wussed out and didn't even want to be there with her when she died than anything (but thats another issue entirely), but also upset cos I took care of her alot and she was a challenge.... I was praying she would overcome the odds. It is only human to care about people... don't lose the humanity that makes you a better person for caring for your patients.

Missy (hugs)

[chaosRN, ASN, RN]

((((hugs))))) It's only natural to get attached to someone you spend that much time with. When we have a patient on the floor (CVICU) for weeks or months at a time and they pass away, you can't help it but get a little teary-eyed. I think I've only teared up twice. Once was a pt we had for 3 or 4 months. I got really close with the family since he was intubated, sedated, & he passed, expectedly, but it was still sad. The other was the patient pretty much gave up. She had been on the floor for 2 months I think. It was sad to see the family obey her wishes. She was completely with it & all. I don't think you're getting attached, I think you're doing a great job at caring for your patients! :icon_hug:

[Antikigirl, ASN, RN]

You were up and beyond your typical call of duty, and you and your patient grew, learned, and enjoyed the part of human interaction that many times we miss in fear of heartbreak. I think that is a wonderful thing, and if I were you...I would be so very proud of yourself, and I am quite sure J. is too!

For me (I worked in an ALF for 4 years), I took care of patients and was a great advocate only on facility and only during work hours. I never visited them in hospital, I never took them shopping, I just couldn't get myself involved like that with one patient when I had 150! I think that saved me from much heartache when they departed this world, and I always knew...I did well by them, and I know I was fondly appreciated!

For me, work is work...yes, it is emotional and you do get attached...but, I have a family to tend to after work...and they see me when I am emotionally and physically exausted as is...if I took on pt care outside of work...they would suffer for it. So I keep work at work and focus on the family when I am with them.

My hubby too is a paramedic, but he understands the close relationship nurses have with their patients. Our roles demand closeness, and finding the balance between a professional work relationship and a down right loving friendship is like walking on a knifes edge! Nurses are compassionate to a fault sometimes on this...but we are HUMAN...that is a wonderful part of humanity!

Alas, you will learn so much from this experience...as I am sure you are realizing. Look deep into yourself and set tenitive boundries on how much you wish to do and still remain a positive, proactive, helpful nurse to your patients. You will find your balance, and believe me, it changed with each wonderful individual you have the pleasure of helping!

You made a significant difference in a life...be proud of that!!!! You gave of yourself to better someone else, be VERY proud of that (we need more of that in this world). Remember the fun memories and the heartfelt joy...and most importantly remember...she is a part of you forever and will become a strong force in times to come as you continue your efforts as a compassionate, caring, helpful, friendly, professional nurse and person!

Bless your heart!

[Tweety, BSN, RN]

I think your action was more than appropriate.

[KScott]

Whether you knew her for a minute, or a lifetime, it is your right and need to grieve. Your mind, body and spirit has a process it needs to go through to come to terms with certain events it is presented with. While you would not want to "fall apart" in front of patients, etc., you have every right to "fall apart" at home, if that's what you need to do. Allow yourself to feel your loss and the joy of having known this woman. Hiding your feelings from yourself, and those close to you, will only prolong the grieving process and IMHO may intensify each subsequent loss until you can no longer handle the pain of your job. Let it out and, when you're ready, let it go.

[Guest717236]

Whether you knew her for a minute, or a lifetime, it is your right and need to grieve. Your mind, body and spirit has a process it needs to go through to come to terms with certain events it is presented with. While you would not want to "fall apart" in front of patients, etc., you have every right to "fall apart" at home, if that's what you need to do. Allow yourself to feel your loss and the joy of having known this woman. Hiding your feelings from yourself, and those close to you, will only prolong the grieving process and IMHO may intensify each subsequent loss until you can no longer handle the pain of your job. Let it out and, when you're ready, let it go.

Entirely and beautifully stated by K Scott.

My sympathy on your patients passing. Know that she is in a

better peaceful place and was touched by your loving care

in her time of need.....

[santhony44, MSN, RN, NP]

You can't and won't get that attached to every patient that way.

However, sometimes you just can't help getting attached to some. I think that if you ever get to the point that you don't get attached to anyone, you don't need to be working with people any more.

It's perfectly OK to grieve for this lady. You did help make her last months better, so remember that and remember her fondly.

[ava'smomRN]

its totally normal and a reminder that you care and love your work!

[indigo girl]

You are a shining example of what all of us aspire to be. Grieving is normal and natural because you care. When you see someone everyday, and become fond of them, of course you will miss them. How could it be otherwise? You are not a machine. Some healthcare providers who only see someone for a short time, can distance themselves more easily. In fact, in order to do their jobs in some terrible circumstances, they learn to put their emotions on hold, and this can come back to haunt them later as post traumatic stress syndrome and the like. Allow yourself to feel and to grieve.

You are honoring your patient's memory, and what she meant to you because clearly, she did mean something to you. You will have many losses in your lifetime. Some will be family or friends, and others, people who you have taken care of in your work. I can't say that it gets easier with each loss. They say losses are cumulative. It may help to develop a meaningful ritual to celebrate what each person meant to you, doing something in honor of them.

Love stays in the heart forever, and it also is cumulative. Respect your feelings of loss, and learn to acknowledge them as a sign that love exists in

this world. Too often, we forget what it's really all about on this planet.

[emllpn2006]

I feel it is perfectly okay to grieve the loss of a patient. When you are feeling blue just remind your self that even though you did not know this patient only had a small amount of time left on this earth, you made that amount of time she had more enjoyable for her. I nursing school we were told that it was okay to shed tears even in the room with the family and that sometimes the family is even comforted knowing that some one cared about their family memeber as a human being in their final days.

[Antikigirl, ASN, RN]

I forgot to mention...during my 4 years in ALF, I lost many patients due to their conditions and age. Par for the course and yes...I grieved!

After a while...they weighed on me heavily, and the grieving part of me was taking its tole on my entire life.

I came to a descision to start up a lovely album about my patients...so I could see the lives I touched, and feel good about the time I had with them! That really helped me!!! I had all their obits done in cheerful scrapbooking, and a little memo, poem, or what not that I wrote for them...or even a funny story!

That helped me so much, and I can look back at not only what I did for them, but their memory is a delightful thing to look back on every time I open that book!

Who knows, I keep threatening to write a book LOL! I will more than likely use that to remember the fun and zany times...yes, and even the grief of loss I have endured over the years....