Withdrawl of Life Support in the PICU

carolmaccas66, BSN, RN · Nov 21, 2010

Meant to add also if she is very young, this could be too hard for her. It is different when u have a bit of life experience, and a comfortable philosophy for you that helps you thru life.

Esme12, ASN, BSN, RN · Nov 21, 2010

gotta do what you gotta do. can't be timid about the situation. you might face this again many times. death is a natural process, very natural. you can't fight death. yes you feel sorry for the family, but it was not your fault that life support had to be stopped. why grow gray hairs worrying about this? what's done is done.

AH! the troll is out from under the bridge! HELLO TROLL! :devil:

Esme12, ASN, BSN, RN · Nov 21, 2010

I understand what you are saying to a point, but who isnt a little freaked out at thinking about their first death as a nurse. I know I sure as hell am. I dont care if someone is 100 or 1 day it still freaks me out to think about dealing with it yet I know I will have to at some point and I will do jsut fine. I believe its the families reaction that will get to me. Im emotional. i cant help it. (my life is an emotional health risk!! hahaha) I dont believe emotions make people less than in the nursing aspect. (i know you did not ever say that just sayin) I believe having compassion and feelings are great things for nurses to have. Anyway Im kind of babbling because its so late. With all due respect to you johnnyBeGood! :)

He's a troll!

BluegrassRN · Nov 21, 2010

If my baby were dying, I would want a nurse with whom I felt comfortable. It would comfort me all the more that the nurse cared enough to become emotional and cry with me.

NicuGal, MSN, RN · Nov 21, 2010

Is anyone ever truly comfortable watching the parents endure this? No. Are any of us truly comfortable with this? No.

By all means, she should talk to a mentor about this, but to not assign her would be doing this family an injustice. Like we have said, this is part of PICU and you have to do it if you are going to survive working in there. And if the family sees her, and she does have a great rapport with them, they will be more saddened and upset that someone that they have trusted so much wouldn't be there. What does she say if they ask her to be there? sorry, ca't do it? No, you pull yourself up by your bootstraps, put on your big girl panties and get in there and help that family as much as you can.

Even after 24 years, I still don't like it. To lose a child is devastating. I wouldn't say I am hardened, but I have learned to keep myself together to be there for those poor families that have made the most selfless decision a family can ever make.

VivaRN · Nov 21, 2010

Carol, I have to disagree as well. I was a young nurse in the ICU and learning this is part of the process. Age has very little to do with it. One can be young and also possess maturity and empathy.

Not knowing what to do is also normal. It doesn't mean the OP shouldn't do it, it means she needs to seek support as she has here. It's all about knowing what to expect. There have been some excellent responses.

It's just not something they teach you in nursing school. IMHO, once you've done it once you feel more comfortable (as far as the mechanics, the procedure - NOT emotionally!) the second time around.

Esme12, ASN, BSN, RN · Nov 21, 2010

To the OP. If it ever stops hurting..... that's the time to worry. It's OK to shed a tear or two. Let the family know you are sad. If you need a real good cry ask to be excused when all is said and done and have a good one! Then get up,brush yourself off, say a prayer, and look forward to tomorrow.

Being a NURSE means......

You will never be bored.

You will always be frustrated.

You will be surrounded by challenges.

So much to do and so little time.

You will carry immense responsibility and very little authority.

You will step into people's lives and you will make a difference.

Some will bless you. Some will curse you.

You will see people at their worst-and at their best

You will never cease to be amazed at people's capacity for love, courage, and endurance.

You will see life begin-and end.

You will experience resounding triumphs and devastating failures.

You will cry a lot. You will laugh a lot.

You will laugh a lot.

You will know what it is to be human and to be humane.

Melodie Chenevert

RevolutioN2013 · Nov 21, 2010

One of the last deaths I was involved with was very touching. The parents held the baby while the entire family and doctors, nurse (me) and chaplain all held hands in a circle surrounding them while a family member prayed for them.

What a beautiful thing...I know there is nothing that can make this sort of thing feel "right", but having recently lost my grandmother and having been alone with her at the hospital I can tell you that I wish I had had the benefit of a supporting group. I think that the ability to share our pain and grief is important and I think having the presence of the medical staff and chaplain is wonderful. I hope that this family will have access to grief counseling afterward. I have dealt with some obvious post-grief loss symptoms in the past few months and it wasn't my infant child who died. I can't imagine the emotional trauma that sort of loss would incur. My heart goes out to the family and here's wishing you the strength you need to do what you need to do and help this family.

Good luck and hugs :redbeathe

SBarn · Nov 21, 2010

What an honor, and a burden. I think you have gotten a lot of great advice already but I wanted to let you know I will be thinking about you and the family Monday.

Also, I am sure that the nurses in your PICU are familiar with it, but there is an organization of photographers who volunteer their time to capture memories of the baby with the family. It is called Now I Lay Me Down To Sleep. You can go their website at Home - Now I Lay Me Down To Sleep. I have a friend who volunteers with them in my area. If you will be in the PICU long term you may want to contact them and get the names of some volunteers in your area for when you face these situations again.

madwife2002, BSN, RN · Nov 21, 2010

Thread moved here as it is a speciality thread and you may get more answers

nfahren05 · Nov 21, 2010

I am a new grad and work in the PICU. For the past few months I have been periodically assigned to care for a patient bumped from our NICU. The patient was born with a genetic disorder and after coding a few times and deteriorating the family has decided to remove the patient from the ventilator on Monday. Today, the charge nurse told me that she and the MD's felt I should care for the patient on Monday because of the rapport I have established with the family. I don't know what things I could do to provide comfort to the patient and family. I am also worried that I won't be able to control my emotions and be supportive. Please help!

Withdrawal of care is a team effort, and all members should be involved, don't feel that it's all up to you. Be reassured that familes don't necessarily want you to control your emotions completely: as long as you are able to function, a few tears are entirely appropriate to the situation. Where are your unit's social worker and case manager in this process? It might be helpful for the family to have their child moved to a hospice program (whether inpatient or at home,) so that end of life support could be given by a team more accustomed to palliative care. The NICU and/or PICU's social worker(s) should be able to help the family with counseling and bereavement, and the hospital chaplain could also be called in, if the family desires this type of support.

justbarbi · Nov 21, 2010

He's a troll!

I should have known that. My message boarding skills are a bit rusty. Its been a long time since I have actively participated on a board. Used to be able to spot a troll from a mile away. Saw the name on a few more threads last night and kinda figured it out. Thanks for the heads up Esme12....