10 year old died after I performed CPR

Nurses General Nursing

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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.

Yes. I know exactly what you mean.

Specializes in Adult MICU/SICU.

That's the price of nursing sometimes … after all, we ARE human first. That human nature is first and foremost - everything else … everything else is secondary.

I see a human being with a kind, generous, loving soul deeply affected by grief … the fact that this child was not a blood relation, a friend's child - or even someone known to you prior to this crisis situation matters not: he still found a way into your heart and burrowed in deep. Regardless of whether or not you had any kind of working relationship pre-crisis situation, you now have a bond that needs to be grieved.

This is the hard part of nursing that can be rather sticky, as well as difficult to assimilate and process. Due to the dire circumstances of the scenario you described it can be really, really tough meting out your feelings, thoughts and ideas - which by now may be a whirling dervish of raw emotions. Short relationship or not, regardless of the circumstances it is a situation that has grabbed hold of your psyche none the less.

I've never experienced a private time scenario such as this personally, but my BFF and co-worker did about a year ago. Her response after the incident was very similar to yours. I hear the same feelings she had described echoing down through the past 12 months eerily the same verbatim.

She came upon a one vehicle accident where the boy had hit a tree. He lost control of the vehicle at a tricky turn. When she was driving by and spotted the accident enough time had elapsed that few neighbors and passersby had stopped - and although EMS had been called, no one had yet attempted to start CPR.

He was trapped behind the wheel, as the front end had become a metal accordion. She did CPR sideways standing from the driver side window, which had shattered upon impact, cutting her forearms, and bruising her ribs on the R side (all discovered days later after the adrenaline wore off). Eventually EMS arrived, and called him deceased within a couple of minutes after taking over. At this point she skedaddled - wishing to avoid being detained by LEO's.

The boy was 18 y.o. and was just about to graduate from high school. 18 … he had lost control of the car because he had been texting while driving. His passenger (his girlfriend) had walked away with some minor scratches and a couple of bruises. While his friends were preparing for graduation that night his parents were making plans to bury their child.

Turns out he was a very close friend of a co-worker of ours - she knew him since kindergarten, and she and her son had done Irish dancing with him for years. He was a good boy, whom went to a Catholic high school here in town. The despair was thick enough to cut with a knife and serve sandwiches on.

My friend went over and over the scenario again and again … we talked in circles for weeks afterward. Maybe if she had got there sooner, continued on after EMS arrived - insisted they try harder before pronouncing him … et al … he might have survived? Maybe she should have been more aggressive with CPR compressions? She blamed herself, when in fact she was an undesignated hero. She took charge and gave this boy a fighting chance that he wouldn't have otherwise had before her arrival, but she did everything but put on a hair shirt, and switch herself with a sappling branch tormenting herself. She felt guilty because he didn't make it despite her best efforts which weren't ideal due to the scene of the accident.

She also wanted to reach out to his family to comfort them, but never did. It was a confusing mishmash of events at a traumatic time.

You see, she had established a relationship with this boy she had never met, and because this tenuous bond snapped prematurely with his passing she grieved. And she grieved hard.

It took some time for her to recover from the shock of what had happened, and slowly life returned to usual again, but she was never exactly the same person she had been prior to cresting that hill that day. The way I see it, this boy took a little piece of her heart with him on his journey beyond - to bigger and better things … and he left a little piece of himself behind in it's place. Even though they never met previously they had established … something personal. A relationship of sorts, for lack of a better word.

You did whatever you could that day, and you went above and beyond what most people may ever offer in the same circumstances even if they lived 6 lifetimes. You are obviously traumatized by the events of that day, and it will take some time to process and sort through. But allow me to mention now that you too are an undesignated hero whether you want to be, or not.

The nurse (and perhaps mom?) in you kicked in on autopilot, but before that - before everything else, we are in fact still only human first and foremost.

Please allow me to humbly thank you for doing everything that you could possibly do on that day.

Specializes in CAPA RN, ED RN.

How very wonderful of you to have been there for this child and his family. Even if they do not contact you again, there is no doubt in my mind that they will remember your kindness and that you did your very best to give this child a chance.

Life and death are always beyond our reach. I worked for 35 years as an ED RN and people that should have lived died and people that should have died lived. I was just there do to my very best to give them the chance they needed. We are given the privilege of being there and using what we have.

I know it will help to talk to someone. It also might help for you to look up the stats on how soon someone needs ACLS intervention to have a good outcome. Even then, it sounds like there were underlying health issues.

Hugs. I cry with you.

Specializes in Med/Surg.

You had done everything you could have done to try to save his life. If there was a AED, maybe he would have a better chance. Bless your heart. Don't feel bad.

I'm so sorry that you are going through this. Please know that you did everything you could. You showed courage and acted quickly and appropriately. But, as others have said, I wouldn't recommend contacting the family. They are grieving and need to be allowed to do so privately. They are probably feeling some of the same things as you- questioning their role within this tragedy. They are also probably feeling a sense of responsibility, wondering if they could have done anything to prevent this boy's death. If you reach out to them unsolicited, it might not be an interaction that gives you the solace you are looking for. The family's emotions are likely heightened and they might misdirect their own guilt, anger, or frustration towards you. Please take comfort in the fact that you gave their loved one a chance. And whether the family is able to appreciate this or not, you did give him a chance. I hope you find some resolution and definitely use the resources available to you through work (counselling etc.).

Oh honey I'm so sorry. You gave him the best chance by knowing CPR and him surviving wasn't in the cards this time. The boy knew you tried to help and I am sure he was grateful even though he slipped away anyway.

Specializes in ER, Medicine.

You did all the right things. People tend to say things like "if only I hadn't told him to come over" "if only I had turned the corner sooner" "if only I had turned on the lights upstairs" my response is It's NOT YOUR FAULT. We are not God and we don't plan on bad things happening. If it rains it rains. If it's cold it's cold. And the boy didn't die because you didn't get there 34 seconds earlier. He didn't die because you didn't ask what medications he was on. He died because it was his time to go. If it's your time to go it's time to go we can't feel at fault. You did your best but in the end it was already decided.

Specializes in Hospice.

Responding to an unexpected emergency in the community is so different from responding to a change in condition with a patient. We are not prepared for it, we don't have the same resources - there are so many factors at play.

Even responding as an EMT to a community scene is different from being right there when an incident occurs. When I respond as an EMT, I have time to at least at least form a very rough game plan based on dispatch info (subject to change upon arrival/ assessment though!). By the time we get to the scene, I'm in responder "mode".

I've spent some time with other professionals who have been in similar situations to the OP. I echo the previous poster's who encouraged counseling or some type of professional help processing this. I also encourage the OP to engage in self care and allow others to provide support to her. Sometimes we as nurses provide excellent care to others, ourselves - not so much.

Specializes in Emergency.

I'm very sorry you had to go through that. The movies have us believing that CPR saves people, and it does... just not very many. Fewer than 1% of people who receive CPR make it out of the hospital and live normal lives again. You did your best and it's doubtful that anything you could have done could saved this child's life. You might consider talking to a professional about this. Unresolved guilt, even undeserved, can be very unhealthy.

God bless you. I really don't think that you need to be hard on yourself at all. It sounds like you did all of the "right" things. You saw that the grandmother needed help, and you jumped right into action. I think that if anything that family is grateful that you helped them. You really did not have to, but you jumped right into action and tried to save that little boys life. You don't know what happened to make that child become unresponsive, he may have needed a lot more than CPR depending on his condition. Again, don't beat yourself up, you did a noble thing.

Specializes in Med/Surg crit care, coronary care, PACU,.

You are dealing with a very bad case of "what ifs" over a seriously traumatic experience. Your feelings are real, and are akin to PTSD. PLEASE if you feel this is taking over your life, can't eat/sleep, talk to a counselor...psychiatric, or spiritual. These feelings are natural, in everyday life, 10 year olds don't suffer cardio-pulmonary arrest. I have been part of a code team for 20 years, and every code is traumatic, especially the young ones. Emotional support, and time are the best healers. I'll wager the grieving family was comforted knowing that you came to help, even though it was not the outcome anybody would want. Big hugs for you.

Critical Care Nurse and Paramedic here. I work in a cardiac ICU and see death on a regular basis. As a medic, I am on scene for the most horrible tragedies. Believe me, it's the kids that stick with you. I've worked drownings of children, so I know the frantic scene of which you speak. I always remind myself of three things: First, "This isn't my emergency. I am the backup unit." Second, I always remind myself, "I am not God. I don't get to pick who lives and dies." Third, "It is a holy moment as people are passing in an out of this world. I have the honor of being there as infants are born and I have the honor of holding their hands as they draw their last breath." You can do everything perfectly and people still die. One of my fellow paramedics was killed last year on the scene. It happens.

Hold your kids and loved ones a little closer. Reconnect with faith. Be more generous with your time and money. Take an extra moment to connect with your patients. Show the difficult ones an extra measure of grace. Hang in there and remember all the good you've done.

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