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I'm feeling morbid. What is the worst death you've seen? I work in a MICU, so we don't get babies or gunshots (or babies with gunshots; they do in our ER, true story.) but we see some pretty dramatic stuff. A patient dying doesn't bother me too much because most of my patients are so sick that it is a relief to send them off to the happy hunting grounds. It is the family they leave behind that holds onto me and won't let go.
We had a teenager sent to us from the hem-onc floor because he was in ARDS. He'd been sick since he was 12, and now he was really sick. He was on the oscillating ventilator all night and his sats just kept dropping; 70, 60, 50. He coded just before change of shift and when he bradied down and half the unit ran in to crack the code cart that had been sitting there all night, his mother started yelling, no no no, and it still makes me cry just to think about. I don't think anyone who was there that night was unaffected; we usually don't get kids, and it hit too close to home for most of us.
I have a lot of respect for those of you that work in peds because I could not deal with something like that more than once in a lifetime. I had one other patient when I was working on a med-surge floor, who had been using crack and ran a stopsign with her baby and her seven-year old. The baby died (we couldn't get ahold of the trauma team all day because they were working on him) and she was my patient with two chest tubes, and the pediatric surgeon came down to ask me if I thought she was stable enough to go say good bye to her baby because they were going to take him off life support. It wasn't a death that I witnessed directly, but I went home crying for three days.
worst death would have to be qualified as the "goriest" or the most tragic.
I've seen several people pour flammable liquid on themselves and light it up. Those were incredibly horrible, they each lived for several days and died in the burn unit.
an 9-y.o. boy shot himself in the head, according to his siblings he was afraid because his father had said "You wait til I get back home!!" I always wondered what horrible things had transpired in that young life to make him think that being dead was better than waiting til his father came back home.
I walked into an apartment and found a family hacked to pieces. the young daughters were beheaded and eviscerated. fortunately they caught the guy and he was sentenced to the Chair. that scene is still vivid in my mind.
what's always struck me as odd is that people ask about the worst experiences but rarely ever does anyone ever ask us: "what's the most triumphant thing you've ever experienced?"
I hope everyone has a good night/day and stay safe and careful.
Great thread and thanks to everybody for sharing their stories.
I've seen quite a few deaths in our post surgical ICU:
- chests cracked wide open in the bed.
- families at the bedside witnessing the code and passing out in the hall. "Call a different stat team, because we're all busy in here!"
- post surgical patient mottled head to toe, doubly maxed out on all drips, hanging blood as fast as I can get it, alarms on everything ringing that I can't lock out, perfusionist who's running the ECMO yelling at me to "fix it!" while doc says "You're doing great, keep going!" Guess the doc called the NP early because she came in, peeked around the curtain, looked at me and just shook her head. They finally stopped sometime during the 2 hours I was there charting. Imagine the look on the nurses face for the next shift who had to take over from me!
- long termer, same age as me (within days), wasting away over the period of a year (can't say any more than that) Skin and bone, crapping blood a dozen times a day. Finally infarcted his bowel. Good guy too.
- another long termer who was severely infected with drug resistant bugs and could never leave his isolation room. Ever. Although he was on heavy life support, he was fully lucid and eventually agreed to have support withdrawn. Family came in for Thanksgiving dinner - turkey, mashed potatoes, cranberry sauce, the works - which he ate and probably aspirated into his lungs. Entire family all dressed up in their isolation gowns, they still had a great time together. Next day, the time came. The nurse (not me that day), shook his hand, gave him a huge bolus of Fentanyl (don't ask how he got it), and turned him off. That nurse had to turn a couple folks off, and quit soon afterwards.
There are others that stand out, but none hit home more than one of the ICU docs who was driving home one morning and was killed in a car accident. Completely not his fault, just bad timing. That hit everyone in the hospital hard. Come to think of it, we had a nurse that was killed in a car accident on one of her days off too. Shocking.
The thing about working in the ICU, is that you rarely see the good endings. Folks transfer out and they are out of your life forever. You ask the NPs "How's so and so doing?" NP: "Oh, fine"
This thread just about tore me up. I just lost a patient this weekend (I'm on sub-acute rehab, so occasionally we'll get an end of life patient but they are few and far between in my setting) and while his death was quite peaceful, it's still pretty fresh for me. He died of CLL, and I witnessed the slow decline over weeks with periods of rallying, and then much more rapid decline towards the end, and was quite close to his family (was his primary RN for close to 2 months). Once he decided on DNR status he just seemed to relax and let go. I spent 16 of his last 24 hours with him, and I consider it an honor as well, as a PP mentioned.
I would have to say the worst deaths involve suffering and my personal helplessness to relieve that suffering. The guy who died of the pain of a broken back when I was so new that I didn't know how to give appropriate doses of morphine, that was bad and it set me on the path to becoming a much better nurse. The patient who became a DNR right as she bradyed down, on a vent, after eight excruciating hours of fighting her coagulopathy was really bad and it still gives me nightmares. The doc wouldn't come pronounce her, the respiratory therapist was hiding from the unit (don't ask), and we had to wait 45 minutes on the ER doc to have time to come do the honors so we could take her off the vent. During this time her daughters stood there and watched their mom's corpse being ventilated. I still am not sure how I managed to go to work the next day, and I see her face even now and hope that memory will fade.
The most triumphant moments in nursing for me, are when I did my best and luck prevailed at the same time, or when there was such good teamwork that it didn't matter how badly things were going. One snowstorm comes to mind, when we were all stuck together for several days on a unit full of people with diarrhea. Poop rounds in teams was awesome! You had to be there, I guess. Also high on my list is seeing people I precepted have some really good shifts working, and being able to say "I'm proud of you." There is also a lady I think of, whose condition was so bad, that her death very possibly could have been a whole nother dimension of suffering, that I am so happy I nursed her because she did not, from what I could tell, suffer. I worked very hard keeping her umm... presentable... and gave her adequate sedation so that, as the family put it "she doesn't have to know anything about how this feels" and she managed to look pretty and die peacefully. In that same week a patient I had who was needy, whiny, manipulative and mean, somehow managed to stop all that bad behavior long enough for me to help this other lady pass with dignity, and we had a much better relationship after that experience. I love it when people step outside of themselves to help others.
Ok time to go read something happy now!
Worse death I saw was a bubby that died just after he/she was born. I sat with the mum for quite a long time and grieved with her. I remember it vividly, more so because the Italian cleaner who witnessed some of this was absolutely disgusted and didn't think it was right. But I was trying to explain that this was the mother's time to grieve and say goodbye. I was only young then, and was struck later on as to how much the baby looked like a wax doll.
It still haunts me sometimes, but it does all get better. I philosophise and justify death now as being part of life - someone may live for 8 minutes, others live for 80 years, but they have had their life, now it's over. Time to grieve and think about the good times, the future, and try to move on, day by day.
The worst death I've been witness to I'm not emotionally ready to talk about yet. However, in the wake of Katrina hospitals in neighboring states were called upon to take in patients from New Orleans hospitals. My hospital received about 18 nursing home patients who had simply been scooped up and brought out without arm bands or charts. Some of them died on the way to us. I was receiving my first NH admit but the lady took her last couple of breaths as we took her off the stretcher. This tiny elderly lady was somebody's mother and grandmother but we didn't even know her name or who to notify. Family may not have ever known what happened to her. I was moved to tears.
A fellow nurse hid her breast cancer diagnosis from us. She was an amazing lady, a hard worker, a fantastic nurse. She took a personal LOA but we didn't know details until her husband called us to say she was admitted in XXX hospital and if we wanted to say goodbye now was the time. She died a few days later. I hope she knows how much we all miss her!
I have been fortunate to not have witnessed a patient's death. My co-workers commend me on my ability to sense when they are taking a turn for the worse and I have so far been fortunate enough to have them transferred.
However I have taken care of some patients who were clearly not doing so well with death being imminent. The hardest was a woman with cancer who suffered a completely unforeseen, unrelated complication. I think I must have spent 10 of my 12 hours of the shift with her at her bedside trying desperately to figure out what was going wrong while the family members converged on her bedside thinking that it was her time to go. Thankfully after asking the doctor, and in desperation or exhaustion, him granting my wish to perform a battery of tests and consult numerous specialists they were able to figure out and reverse the complication and she was able to go home before passing later from her initial diagnosis. Theres not a day I go to work I don't think about her.
I agree with the other poster's who have said that despite how difficult it is for us, being with those that are passing can be an incredible gift and great honor.
I work Adult Medical, so I don't tend to experience the kinds of deaths y'all have described.
However, one case has really saddened me.
There was a young man roughly my age who had a chronic condition requiring numerous surgeries since birth, and ended up developing a very high tolerance for opiods. He was a very nice young man, though, and hoped to one day be a nurse, if he could only stay out of the hospital long enough to finish his classes.
Well, his mother was a patient of mine. We ended up sending her home with hospice when it was realized that her COPD was end-stage and she wanted to be comfortable and in her own bed rather than on BiPap at all times. She passed peacefully.
Her husband (patient's stepfather but the man who raised him) sort of "gave up" after his beloved wife died. He experienced respiratory failure around the holidays. It was coupled with DIC and sepsis. Because of his known wishes, care was discontinued and he was placed on my floor on a Morphine drip.
Well, a few days after the stepdad was placed on hospice care, the patient who was my age gave up himself and intentionally overdosed. They couldn't resusitate him in the ER.
I work in an MICU also (well, past tense) and i never saw pediatric deaths which I am sure would take the cake. But I did have a pt about 1 month off orientation who was 60, young, AAOx3, lung CA pt. They had to extract a clot from his lungs, not done in my hospital, but beds were not available in the other facility. He was a ticking time bomb. Well, all was well, he was sleeping nicely (night shift). he woke up to pee, I saw him standing there using the urnial. Well, he started coughing and there was blood just spurting out of his noseand his mouth and he new it. He kept saying "get me oxygen" and he spurted blood until he coded. We didn't get him back. It will always stick with me.
To make it worse, I had this horible pain in my right shin. It looked like an ingrown hair. On my way home after that horrible shift, I couldn't even press the gas pedal. Stopped off at a different hospital ER to get it checked out. They did and I&D and turned out I had a MRSA wound!. Gotta love the ICU!
cherrybreeze, ADN, RN
1,405 Posts
I agree. I have always felt that giving such care at end of life is an honor, too.
Just had that talk with my aunt's nurse yesterday, and my cousins. That, while it is hard to care for someone through their last journey in life, it is so humbling to be the one that makes it what it is. It is an awesome responsibility. That includes the care after their soul has departed. Maintaining their dignity throughout does as much for the caregiver as it does the patient.
I understand the sentiments expressed about the theme of the thread, and so far, I don't think I've seen anyone trying to "one up" anyone else. Just sharing some of the stories that are the hardest parts of being in this career. A couple of posts made me cringe a bit in the way they were worded, though. I won't pick them out specifically, I'll just leave it at that, and give those posters the benefit of the doubt that they didn't intend to come across how they did.