7 weeks off orientation: First death. (Need support..)

[swedishnurse]

Hi!

I´m just 7 weeks off orientation and I really like my job. Most of the time I feel I´m doing ok, eventhough I´m still anxious about going to work every day. So last night it happened, one of my patients died!

I admitted her from the ER at around 5pm. She was a 94 year old woman with SOB, suspected pneumonia. Her vitals at admission: Resp rate 40, SpO2 around 95 on 5 l O2, BP 90/60. Her vitals stayed the same the following hours, but she was feeling a little bit better, felt it was easier to breath than when she was in the ER. Eventhough she was not getting worse or anything, at around 1930 I get this gut feeling that I should probably call the doctor to make him aware of this patient. Didn´t have much to tell him, since her condition was pretty much the same, but I gave him the info and he says he´ll come by later on to check on her.

Around 45 minutes later the alarm from her room toilet goes on and we all run over there and she has passed out on the toilet. She is barely conscious but we get her to her bed and start taking vitals and doing EKG. I call doc, he comes up in 2 min. I go outside to call her family and when I come back into the room she has passed, doctor decided not to start CPR.

Later her family arrives and they are very happy that she could go so peacefully. Her worst nightmare had been ending up in an old age home, so they were really happy she didn´t have to.

Afterwards when one of my coworkers asked me how I felt I just bursted out in tears! Everyone was really nice though and understanding, telling me I did everything right and that it was just her time to go. I still felt soooo bad! And I really need your support!!!

[NursingAgainstdaOdds]

You did what you should. *hugs*

[Doubledee]

It used to be that nurses were expected to be "professionally detatched", but not anymore. It is OK to cry

Professionally detached is a relative term.

It is no shame to feel and grieve and even cry. Detachment, to me, comes in when you have to move on and take care of the other patients/residents on your assignment. A person may have died but the living still need us. We have to get it together and take care of them too.

Fortunately, nursing is a team sport. Our coworkers are usually there to pitch in when we need help just as we will be there for them when they need it.

[cpnegrad07]

I'm always surprised at the variety of pre-death signs in different patients. Some are overt and obvious; some are subtle to non-existant. If you are kicking yourself for not seeing it coming, think back on what you saw. Have you seen other patients with the same presentation who did not die?

I think you have to keep trying, with each patient, to perfect yourself. And don't linger on the past--learn from it.:balloons: Hoping you are OK now,

--me

[txdude35]

I've been in the ICU for about a year now, and my first death was terrible. For days I questioned myself what I could have done differently, but the answer was "nothing."

She was 94 years old and died a peaceful death. I wish I could say the same for many of the patients who expire on my unit. Take it easy on yourself and understand that she was spared a lingering death after being coded and intubated, propped up by vasopressors and TPN for weeks. It was a blessing for all concerned.

[DutchgirlRN, ASN, RN]

You did a good job. 94 years old is certainly a long life. Since she could get up to the bathroom by herself I'm assuming she was still ambulatory. That's awesome. I see so many in their 60's & 70's who can't walk and are living in nursing homes. That is much sadder IMO.

[leslie :-D]

i think these deaths are the best way to die.

lol's who are found on the bathroom floor.

they're unforeseen, quick and peaceful.

as long as they're old (90's) and ambulatory, i've never had a problem with their timely death.

leslie

[samarooni]

I think it is terribly sad; I'm a new pediatric heme-onc nurse and I've already had three patients die, one of whom I was really attached to and who died last night. Even if your patient was 94 we still just don't want life to end--it is sad no matter how old someone was or how "full" their life was. Death is inevitable but that doesn't make it any easier. Good luck getting through this.