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.
You did do everything right, and it sounds like no one could have saved this boy. Because I work in the field I do go to things like this and I have learned to deal with them well, people who work in a more clinical environment aren't exposed to stuff like this often and it is hard. It's not that it gets easy to deal with everything, we just have our coping mechanisms in place or we burn out in no time.
Who do you have to talk to? Do you know any long-time paramedics that you trust? We deal with it by talking to each other for a start. A paramedic who is worth a crap will be happy to sit with you (more than once) and help you get started on working this out. Of course I will also suggest a professional to help you work through this. But do get started because it doesn't go away on its own.
Peace and love to you, I know what you are going through but I'm lucky enough to have a huge support system to help me work this out. You need to make or find a support system now.
I was told to tell the story, tell the story, tell the story. In other words, when you talk about it, over time it helps to "de-sensitize" you sort of like little doses of antigens like those given in allergy shots.
Oh wow, I'm very sorry you experienced this. One thing I do want to say that may make it easier is that we only do CPR when the person is clinically dead. His heart wasn't beating and he wasn't breathing, OP. That breathing you heard for a few seconds was likely a couple of agonal gasps. He had passed away and you were brave in your attempt to bring him back. Not all of them come back. You acted as promptly as you could and you performed CPR for a long time until EMT could take over. You did the best that anyone could!
First of all, having a child die is tragic, no matter how much time, care or contact you had with them. First responders, no matter how long they have been working in the field, know this, and they never get used to it. You know how sensitive you are, and that is probably the main reason that you chose your specialty. Try to seek some counseling from you employer, even though you were not at work when this happened. Next, sounds as if you did everything correctly and you did all you could. My last point is that if a child has that type of medical emergency with no apparent cause, there was a severe underlying medical condition that was at fault, and there was nothing that you could have done to save that child. I'm sorry to put it so bluntly, but we cannot save everyone. Try to seek some counseling, and if you can't use your employer resources, try your church, local fire or police department, hospital, social services, or perhaps a local hospice organization. Try to talking to co-workers and see if they have any suggestions. Take care of yourself.
I graduated from nursing school in 1977 and I can still remember my first code.He was a gentleman who had a total knee who shot a PE when we were returning him to bed.I still feel the same anxiety when I think of him.Since then I spent 28 years in the ER and 14 years in psych.I can't remember all the codes I've participated in while in the ER,But I remember the room,his face removing his dentures
and who was with me when he coded.There are some things that are always with you.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
Giving you hugs and holding you in my thoughts.
This was not your fault.
You will start to think about it less and let it go as you process it and time passes. Reassess yourself 2 weeks from the incident. Then again in 4 weeks. At 6 weeks, if you find you are still obsessed, talk to a therapist as you may need some help processing.
Specializes in Peds leukemia, APON, GI in a clinic.
Time is the greatest asset for a wounded heart/soul. For me, crying, praying, anger... were ineffective. Time has taught me that time from the incident is the only effective way to gain perspective and healing. By the way, good job nurse, for jumping in and doing your best. You represented us well!
May I please offer you a few thoughts to consider?
The child DID have an underlying medical condition. Please recall, you said the grandmother told you he had heart surgery shortly after he was born. Even with corrective surgery, we know, he had a medical history which would always be disclosed for future care, for one reason or another. He was always going to have that consideration in everything, going forward.
That child stood the BEST POSSIBLE CHANCE because you DID ACT! Honey, if he wasn't going to make it, you made absolutely sure you gave him ANY possibility that he could defy the odds. The odds were not in his favor, and while I know the sting, we must recognize, we are not Gods. We do what we can do, we help where we can, and we need to let go of that guilt, which serves NO PURPOSE.
It's ok. Say that out loud. "IT'S OK." You were there, you offered your professional assistance without concern for yourself. You did something that will FOREVER help that family know, he was beyond the point of saving. If immediate care, you and the EMTs, couldn't bring him back, then they can have peace in knowing that nothing was missed. Instead of tossing and turning all night, wondering, WHAT IF, you, my sweet, have provided them with some level of closure they would not have otherwise. THAT IS BEAUTIFUL.
If you feel compelled to reach other to them, I say, do it. Maybe send a card in the mail. It really would mean a lot. Offer your phone number, IF YOU WISH, but, I would caution you to keep this at arms length distance. Not to sound compassionless, but, the last thing you need is to hold on to this for too long and to feel compelled to go through every single possible"What If" over the phone with a grieving family. Perhaps, let your cousin find out and then tell you more detailed results. I really worry you might get too involved and wind up emotionally exhausted.
PLEASE talk to someone. PLEASE, go to grief counseling. Find a support group. Start one for other nurses, in your area. Give yourself space and time and permission to move on. It's OKAY. I promise.
I went thru a situation, as a brand new LPN, where my patient had a massive heart attack. I work NON-MEDICAL psych. I called the code as I was doing compressions, and then I directed it, believe it or not, as a first year LPN, with RNs responding. It was a painful, scary, difficult situation.
After my experience, for months, I would leave the room if the tv was on and the characters on TV were acting out chest compressions (movies, TV, etc...) I mean, the first time, I literally JUMPED UP off the couch and RAN to the formal room. I didn't even know I did it until I was walking in circles, wringing my hands in the other room, nearly hyperventilating.
BUT. I knew this one thing -- if MY patient was going to die, I wasn't going to let him just GO easy. NO, I was going to fight like hell, I was going to do EVERY SINGLE THING I COULD to save him. AND I DID. JUST like YOU did. Just like you. He stood the best chance of survival with me, because I wasn't going to stop until I was forced to stop when the EMTS rolled up and took over. (My facility sends out emergencies, we are not set up for medical situations.)
So, here is the take way, and I know this is the truth for you, too. If there was ANY WAY to save him, you were the best resource available. You were going to make sure you did everything you could. His best chances were increased because you responded. YOU DID WHAT YOU WERE ABLE TO DO.
Now, my love, it is time to forgive that we are only human.
IN TIME, you will be able to put this to bed and it will make sense that you were the best chance he had, and he was never going to revive. Those agonal breaths and weak pulse were not indicative of survival. It was a biological response. If EMTs with meds and machines couldn't do better, honey, it sounds to me like you were pretty amazing.
Please talk to someone. Send a sympathy card, if you feel like that is the right thing to do, but I would caution you to keep some distance beyond that, only because I don't want you to get consumed with this. Rest in the knowledge that you did all you could.
First of all, I am glad you were able to help. Realizing that you were able to help, despite the outcome to help alleviate some of the stress you are experiencing. Unfortunately, it is the harsh reality that sometimes the best outcome is not resulted. I hope this helps you find peace.
I worked in a hospital ER that doesn't do de-stressing care after events like this. I had a 6 year old that didn't make it. My plea to you is to get a little bit of counseling, because I'm sad I didn't. Over time you will feel better, but never really forget. You were awesome and a real gift to that family because you brought order and a sense of hope to that family at a horrible time in their life. You are truly a great nurse because you care so much. Sometimes there are things in life that we want to know the answer to but just don't get to.
I think God put you there to be their angel at that time.
The PALS course movie where the mom does CPR on her drowned child makes me cry. Having a child arrest and die is just horrendous. I am so sorry you went through this. Obviously you did your best. This is an awful shock. I am sure the family is grateful for your efforts. I wish I could say something to comfort you though I have no idea what to say. I have the utmost respect for you and pray you find peace. You are an amazing nurse.
.thumb.jpg.e7b5bd336d518053002d5b4dbeef882b.jpg){kind=small}
BeenThere2012, ASN, RN
863 Posts
I was told to tell the story, tell the story, tell the story. In other words, when you talk about it, over time it helps to "de-sensitize" you sort of like little doses of antigens like those given in allergy shots.