10 year old died after I performed CPR

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This is my first post after many years of reading allnurses posts written by others. I'll give a brief background on myself... I've been an RN for 11 years, working in both the OR and home health. I never had any interest in critical care nursing as I know how sensitive I am and that I would likely not be able to cope with amount of loss associated with critical care. With that said, I'm having a hard time coming to terms with my grief over a recent incident that occurred outside of work and I'm hoping someone can offer some advice.

Six days ago, I was visiting my cousin and her new baby at their home. We were sitting in her living room, which overlooks her backyard as well as the backyard of her neighbor. Her neighbor has a large inground pool and there were 4 children (teens) playing and swimming around the pool while an older woman sat and watched them. At one point I glanced out the window and noticed that the older woman appeared to be attempting chest compressions on one of the children who was laying on the ground but she obviously didn't know CPR and was frantically screaming for someone to help her. I took off out of my cousins home, jumped over the fence between the two yards and began assessing the young boy. He was not breathing and had no pulse so I immediately began CPR. Between breaths, while doing chest compressions, I attempted to gather information from the woman, who turned out to be the boy's grandmother.

Me: "What happened? Did you call 911?"

Grandmother: "I don't know! He said he couldn't breathe and then just collapsed! Yes I called"

Me: "Any health problems?"

Grandmother: "He had heart surgery when he was born but he's been fine since then!"

Me: "How old is he?"

Grandmother: "10"

And so on... After a couple of minutes of CPR, the boy took a few shallow breathes on his own and I was able to feel a weak pulse. I rolled him onto his side hopeful he would regain consciousness but as soon as I did this, his breathing and pulse stopped. I then resumed CPR until EMTs arrived about 10-15 minutes later. I stayed with the family for about 30 minutes after the ambulance left, attempting to comfort the other children that were present- his 13 year old sister and 13 & 15 year old male cousins. The boy's aunt arrived at the house just before the ambulance left and was also comforting her sons and niece. I left my phone number with the aunt and asked her if she could update me on his condition when she knew more which she promised to do. I then returned to my cousin's home briefly before heading home. Later that evening, I got a call from the boy's aunt informing me that the boy never regained consciousness and died in the ER. I offered my heartfelt condolences and my support in any way needed. When I hung up the phone, I fell apart, sobbing uncontrollably for a long time. I felt like a failure- even though I know that's not a logical reaction. And now, 6 days later, I can't seem to let this go. I think about it constantly and wonder if I could've done more or done something differently. I really want to reach out to his family but I'm not sure if I should. I would like to know if there was an underlying cause of death that was beyond my control. I want to know if his sister is ok and the other 2 boys that were there. I would like to meet his mother and father since they weren't at the scene and tell them how sorry I am that I couldn't save their baby.... I just want to be at peace with this but I don't know how.

Specializes in Thoracic Cardiovasc ICU Med-Surg.

Oh sweetheart. I am sorry. This boy was dead when you saw him. Given that he had cardiac history, that was probably a root cause of his death. You did what ANY good nurse/samaritan would do.

It is normal and EXPECTED for you to have these reactions after a code situation. Especially one concerning a child. It's a traumatic event and that's why you're getting the flashbacks. If you have a counselor--call them! If not, please seek assistance at work with your EAP. They can help you.

What you're going through is similar to many critical care nurses, physicians, soldiers, cops etc go through. It's awful.

You did the right thing. You did your best.

Specializes in Educator.

I am so sorry that you had to go through this. What you are experiencing now is 'normal'. You did everything you possibly could to help that child, you sprang into action and did what you could. I know it hurts, but don't reach out to the family. As others advised, contact your EAP if you have access to one, if not your pastor or a grief counselor (Google one if you don't know of any). Your need to talk this out with someone who can guide you appropriately is real and needs to be addressed.

Hugs to you, remember you did everything you could, I can't stress that point enough.

Specializes in ER, ICU/CCU, Open Heart OR Recovery, Etc.

I'm so sorry this happened to you. I know others have said this repeatedly, so I won't belabor the point; but from what you report about the situation, I can't think of anything else that you could have done. You gave that child the best possible chance to survive that he could have had, given the circumstances.

Thank you for doing that, and for being there :) Regardless of what the family does, or doesn't, do; I'll tell you that.

That said, every death I have witnessed has taken a piece of my soul. I have seen a lot of death, and every one has transformed me. Sometimes they have shown up in my dreams.

What I have found helpful is seeking counseling, either through EAP or from a local chapter of Critical Incident Stress Debriefing. I was formerly a CISD team member, and will attest to both the training I received and the compassion of those that volunteer to be team members. I also allow myself to have the reactions that I have, not minimizing or trivializing the childs death but feeling all the facets of it. When the time is right to say you have begun to move on, do so, but on your own terms. I would also seek out support groups in your city or town if you can find them.

Again, thank you for being there for that child. *hug*

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Wow what you all went through, horrible. I am so sorry for everyone involved. You did all you could.

First, thank you for giving it your all. I think you know intellectually that 10 year olds don't just lose their pulse and stop breathing unless something is really really REALLY wrong. The child could not have been saved-probably not even if it had happened on a hospital floor.

The second thing I say with no malice whatsoever: This is not about you; therefore, it would be entirely inappropriate for you to contact the family. It's not their responsibility to fill you in on details to satisfy your curiosity, give you closure, or ease your pain. They are going through the worst thing a human being can endure. If THEY need to speak with you to get their own closure, then and only then would it be appropriate for you to interact with them.

I feel for you, really. But you did all you could and more than most would have been able to do. Try to make peace with this and move on. Take care.

Specializes in Med-Surg/ ER/ homecare.

I just want to say I am so sorry, but again, as voiced by others, there is nothing you did wrong and nothing else you cloud have done.

God Bless you lady! Prayers for your peace and solace!

Specializes in allergy and asthma, urgent care.

I'm so sorry this happened. Your feelings are totally normal. I experienced something similar at the beach last summer with an adult. He had a cardiac event while swimming and we could not re-start his heart. I was devastated, even though logically I know I did my best and there was nothing that could be done. It took some time for me to feel better. You will feel better, too.

Many kudos to you for trying to help this poor child.

Specializes in PICU, Pediatrics, Trauma.

MjHudd...I understand what you are going through very well. I have been a Pediatric nurse for many years and the last 20 or so in PICU. I have experienced a reaction very similar to what you describe and was off work for about a month afterwards r/t a traumatic experience I had at work. There is so much I want to say, but this is what I feel is most important at this time. I am not a psych nurse or doctor, but I am pretty confident in saying you are experiencing a form of PTSD. I think you should contact someone from your EAP department if you have one, or get a referral from your PMD to see a therapist who is experienced in PTSD. I know this sounds dramatic, but I believe you need this type of support now and at the very least will help you through this before it possibly becomes destructive to your personal and/or professional life. If you would like to private message me to talk further, please feel free to do so.

As a result of what I went through, I have learned a lot about this. You are not alone, as many health care providers, Police officers, Fire fighters, EMT's and of course military personal go through this at one time or another, to one degree or another. It doesn't matter how experienced, wise, knowledgeable, etc. one may be. It is actually a quite healthy/normal response, but one that often requires some assistance to overcome.

Specializes in PICU, Pediatrics, Trauma.
All of your feelings are normal responses to what you have been through. When we have events like this in the hospital we have a process in place to give the involved staff members an opportunity to de-stress called a Critical Incident Stress De-Briefing (CISD). As a private citizen I encourage you to utilize your employer's EAP program and do it soon. This is not something that should be put off as there are frequently unexpected consequences when a person suffers an emotional trauma such as this. The EAP staff can help you process what happened and make good choices to take care of yourself. I can't stress enough how important it is for you to do this.

As far as contacting the family. At this point, as much as you'd like to, this is not a good idea. For either of you. If the family wants contact with you they will reach out. Until then it's best to just stay out of their grief for the time being and deal with your own emotions.

Yes! They may very well want to talk to you, thank you and so on, but it should be when they reach out. As long as they know how to contact you, that is all you should do as far as this is concerned.

Specializes in PICU, Pediatrics, Trauma.
^^^better advice. You can send simple condolences to the funeral home but not explain your role.

The family has your contact info. If they wish to reach out it must be on their terms

Perfect. What she said...

Specializes in PICU, Pediatrics, Trauma.
Most CPR is not successful. I know you probably know already know that intellectually, but since you report working in areas where it's uncommon to perform it, you probably have not seen it often enough to truly internalize that truth. Movie and tv CPR is nearly always successful, so many people, even health care professionals, feel on a gut level like if only it's done properly, CPR will always bring someone back, and not just back, but back to their original state of health and function.

In reality, only a small fraction of CPR patients achieve ROSC, and an even smaller percentage of those survive any length of time with any quality of life after that. It is a last-ditch effort to save someone who is otherwise already dead.

In performing high-quality CPR when no one else present knew how, you gave this child his best chance at survival. That it wasn't to be is not your fault- it's the reality of death, which is only very rarely reversible. Hopefully, with time, it will give you and the boy's family consolation to know that his death was not due to a lack of effort or the fact that no one present could give CPR.

I imagine the grandmother's guilt and sorrow over not knowing what to do has been eased by the fact that someone else present did know. Thanks to your efforts, she does not have to live with the terrible "what if" of wondering if her knowing CPR could have saved him. It could not. There is also ample evidence that families who witness CPR efforts have lower rates of depression, anxiety, and PTSD as they grieve than families who were not present. Although his parents did not witness your efforts, his grandmother did, and I think it's not unreasonable to extrapolate from these findings that having more information about how hard others tried to save their loved one is psychologically helpful to survivors in the long run, and that knowing a nurse was present and tried her best to save him may be a source of comfort to the family.

I agree that you should not try to contact the family, and that you should seek a few sessions with a counselor through EAP. Vicarious trauma and grief can have serious consequences, and talking it out with a professional can be enormously helpful. You did your best to take care of this boy, now it is time to take care of yourself.

So very well said.

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