Witnessed a terrible death last night--pls help me...

Nurses General Nursing

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I think I just need to write. I am freaking out. As a new nurse, I expected to have to deal with death. And especially with the population I'm working with, who are mostly cancer patients in crisis. I chose this job because my grandmother, my angel, was once one of those patients--and on the very same unit where I decided to begin my nursing career.

I've been there 3 weeks and witnessed or heard about like 6 deaths already, which is to be expected. The first one I witnessed. She was my patient but I had just come on shift when she died. A caregiver was in the room with her. She had no family. I almost cried that night, but I didn't. I didn't linger on the subject too much after that either. Then I admitted a man with brain mets who was really anxious and in so much pain. I met his wife and daughter, who were grieving, and again I almost cried. I did cry when I left him that morning, and he had just died when I arrived the next night. I though a lot about him that night and the following day. I had trouble sleeping that day. I kept thinking about his family, and about the interactions between us after his family left the hospital the night he was admitted. I can remember word for word most of the things he said to me that night. I still feel sad for them, but I'm not thinking as much about it now. There have been other deaths that didn't really affect me so deeply.

But this morning I witnessed a terrible death. A really bad death. Woman dying of lung CA, unable to breathe, gurgling with each inhalation and exhalation for hours--anxious and trying to sob, but not really having the energy to do so. Her room was full of family, and they were all grieving. I was there when she died, and it was not a peaceful death. I was relieved when the end came, and then spooked to provide post-mortem care, but I did it. I didn't cry or anything like that, even after I left this morning, but I just keep thinking of her. I can see and hear and even smell the experience. I can't sleep. I just keep seeing her face in the horrific grimace and the anxiety just under the surface that she didn't have energy to properly display. The morphine we were giving her every 15 minutes didn't really work, but I think in the end she died more quickly because of it. It almost felt like euthanasia, to be honest, but we were following the orders. What could we have done differently? The sound was incredible, and I'll never forget it. It never seemed to phase the other nurses, but I guess to them it didn't seem to phase me either.

How in the world do nurses get over seeing such awful deaths? I'm freaking out. I've had a panic attack this morning. I just wish I could wash it out of my memory. Does anyone have any advice for me?

Im still a student but I just had a rotation at hospice. I asked the nurses how they deal with so much death and heartbreak around them, and something the nurse said will stick with me forever. She said, "you have to remember its their pain and their tragedy... not yours." I dont know why, but for some reason that statement really hit me.

Specializes in Oncology, Med-Surg, ED.

I worked an Oncology floor and was very happy helping my dear patients and their families deal with end of life issues....until I had to witness my own Mother's death as a result of lung cancer. After that, I found that I needed to switch floors because I was re-living mom's death night and night with my patients. Maybe you need to look at another area of nursing while you are still grieving your loved one.

P.S. As another person said, their is no rule against crying. I have cried with many of my families and patients. You develop close connections with many of them.

Hugs,

Jen

I remember the first time I provided post-mortem care in the nursing home setting as a CNA in a nursing home setting. I also remember the LPN who knew I was scared to touch a dead person and how she walked me through it and ask any questions that I had.

Does your floor have a debriefing after deaths? One place I worked had the oncology nurses have a bi-weekly meeting to "talk it out" because of all of the deaths that occurred.

Crying is a release-you are human. I learned that it was OK to be strong AND also cry when someone you cared for as their nurse and they died. I have had family members actually appreciate the emotions.

otessa

Specializes in Infusion Nursing, Home Health Infusion.

Does your employer have an EAP program where you can go and talk with a counselor? I consider it an honor to help families through this,even though it can be very stressful,you have to be very calm and reassuring and stay focused (which you did). I always tell myself they are lucky to have me help them through this and then I do everything possible to ease the patient and family through the death.

Specializes in LTC.

it is hard everytime you see a hard death but the first does stay with you. your fellow nurses may have seemed to have good poker faces but ill bet they each have atleast one that is always with them. this is not a bad thing it just means you care deeply and that is a good thing. my first hard death was also a lung cancer pt and i gave everything i could ms q15m ativan gel and scop patches she kept holding on and the suffering was horrible! i was fairly new and was at my wits end b/c nothing was working to ease her pain. she had no family so staff rotated so she was never alone. a hospice nurse was in the facility for another resident and saw me about to break down in the med room. she talked to me as if i were the family and told me to just sit down next to her and hold her hand and tell her its ok now. i must admit i thought sure this will help.. but , i did it and my sweet pt seemed to just grin at me and she passed away. i was not happy about her death but very happy she was no longer suffering and i think i helped. i was very very grateful to that wonderful hospice nurse. however, i will never forget my pt and you wont either but you will get stronger and you will help many others during your career. i have no doubt you will be one of the great ones!!!

Specializes in orthopaedics.

:icon_hug::icon_hug::icon_hug:I hope you are starting to feel better. There have been so many words of wisdom here I have nothing to add.

:up:

Tweety, I hear you, and thanks for your message.

Maybe the horrific grimace on her face was O2 deprivation and not anxiety, but she was grasping weakly at her daughter's hand, and I could almost make out "oh god" at times along with all that terrible gurgling.

ATIVAN--yes indeed. I wasn't her primary nurse and I don't know if there was an order for ativan, but that would have worked I think.

How do you resolve the euthanasia issue though, when giving morphine and ativan to someone whose sats are like 40%?

From a perspective by a possiblr future patient and one who has had several family members whose passinf was not far from your experiencelet me say:

I do not consider the relief of pain as using Euthanasia...we do not care if adequate pain meds seem to hasten death....AND why on earth would ya want aloved one to suffer extra hours and more so than if they did not get pain relief??? Well I can tell ya I Don't!

I am not advocating murder..but do not let the little comfort and pain relief you can bring to a patient who is dying anyway make you think you are euthanising them. Letting them suffer is cruel and in

humane...I am not advocating putting people down like is done for pets...But I sure think that whatever dose of meds is needed to stop pain...and maybe lessen anxiety over approaching death is what ough to be done...and the provider of such relief an angel of mercy..not one of death....

You are obviously a very sensitive person.(HUGS).....I hope thigs get easier for you.

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