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.
Think about it like this: the boy didn't have a pulse to begin with. After your cpr, you felt a weak pulse. You exhausted all your efforts and gave everything you had to try to save him. It wasn't enough because he was too far gone NOT because it was you that was performing cpr. Your cpr was stellar. You felt a pulse when he didn't have one before you! You gave him the best shot at surviving. Go back to that moment. Is there anything you should have done differently? My guess is No. Let this be your closure.
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.
Please allow me to humbly thank you for doing everything that you could possibly do on that day.
You have stated this so well. I have thought about how nursing frequently involves an intense though brief relationship. We are there for some of the most intimate moments of people's lives. It is an experience that is unique and difficult to describe the those outside of healthcare.
Disclaimer -- I'm not a nurse. I have 33 years experience as a paramedic and an Emergency Physician.
I, like a lot of my nursing colleagues, have seen hundreds of dreadful things during my career. From time to time throughout my career I have had intrusive thoughts -- where I just keep thinking about the distressing nature of a case even though I don't want to.
What I always promised myself is that I would let intrusive thoughts last for a maximum of seven days. If I kept thinking about a case after 7 days, I promised myself that I would go and talk to a counselor about it.
I don't know what the correct threshold is, but if you are still having intrusive thoughts after a week, you might want to think about visiting a counselor. It might save you a lot of grief or even your career.
I'm sorry. I can empathize with you. You did try everything you could. I like the post above about you changing the name of this post, because you were trying to resuscitate the young boy. He was already gone and you were trying to bring him back. I'm an ICU nurse and know how hard it is to lose a patient. No matter the circumstance it is always difficult. Does your hospital have a Chaplain or counseling service? If they do, I would talk to someone. It never hurts to talk to someone.
I just want to start by saying I'm so sorry you are going through this. My first post on here was similar. It really helped me to hear others go through some similar experiences as well. I know now that it is normal to go back and try to analyze EVERY LITTLE SINGLE DETAIL on what you could have done differently. But you did everything right and everything you could. I think when a nurse loses a patient the first time that they had some connection with, or during their first code it can be difficult. The fact that this was also a child is another factor making it more difficult. What was offered to me, & proved true, is that it may consume you now but every day gets easier. But you will probably never forget. I don't think you should tell the parents you're sorry you couldn't save him but rather give sympathy for their loss. If they choose to open up about his medical condition or if the grandma or aunt provide info it could give you some peace of mind that even with your efforts, nothing could have been done. Don't beat yourself up though. It is a grieving process and talking to others does help.
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.
Ditto...especially your point on how different it is in-house (or rig as the case may be). One time I witnessed a terrible car crash. Blood everywhere, no obvious access to the driver trapped. When I got to work, I suddenly felt like my work is a breeze compared to first responders and I suddenly wasn't as fearful about facing codes etc....It is all perspective and preparedness. A sudden call for help into someone's backyard for a child, and then the sad outcome, would effect anyone very deeply. Even a lay person would worry if they made something worse or did something wrong. You truly were an angel for the grandmother at that time.
I am proud of you for even having the courage and bravery to go over and try to help this boy and his family. It is not your fault that he didn't make it....when it's your time it's your time. No one can stop that. Also I feel that if you have the slightest desire to go by the family and check on them just go! They are going through a tough time right now and just knowing that you even tried to save the boys life is uplifting to them. Don't beat yourself up over it. You will be blessed!
I just want to start by saying I'm so sorry you are going through this. My first post on here was similar. It really helped me to hear others go through some similar experiences as well. I know now that it is normal to go back and try to analyze EVERY LITTLE SINGLE DETAIL on what you could have done differently. But you did everything right and everything you could. I think when a nurse loses a patient the first time that they had some connection with, or during their first code it can be difficult. The fact that this was also a child is another factor making it more difficult. What was offered to me, & proved true, is that it may consume you now but every day gets easier. But you will probably never forget. I don't think you should tell the parents you're sorry you couldn't save him but rather give sympathy for their loss. If they choose to open up about his medical condition or if the grandma or aunt provide info it could give you some peace of mind that even with your efforts, nothing could have been done. Don't beat yourself up though. It is a grieving process and talking to others does help.
Also...first code or difficult experience aside, we ALL have situations we experience that throw us for a loop. The first one that got to me in a big way happened many years into my career. Not to say I wasn't effected by others earlier...just saying many years later I was brought to my knees completely unexpectedly.
You did everything that could be done and in the right order. You controlled yourself and the situation, called for appropriate assistance and continued to care for those at the scene after the boy had been transported.
Your actions gave him a chance where he otherwise had no chance at all. I am sorry he didn't make it.
Cab411
25 Posts
This is very stressful I couldn't imagine
my deepest support on this forum
I agree with letting the family be and if they want to contact you they can. Otherwise best to stay back.
Try reaching out and talking with people about it. This will take time to move on.