Thursday, January 24, 2008

Shell Shocked

My patient died a few nights ago. It was the most bizarre experience ever. I had just been in his room, taking his blood pressure (which was fine), drawing his AM labs and talking to him. I walked him to the bathroom and back, then tucked him in his bed, got him a warm blanket and said goodnight.

I went into my next patient's room to hook up his antibiotics. The Monitor tech calls me and tells me my other patient has a junctional rhythm. I rush in there and he's pale and unresponsive, his head crooked over to the side, his dentures halfway out of his mouth. I instantly freaked and started shaking him, then hit the code button (even though he was DNR). I told the other nurses that he was DNR with chemical intervention but his heart had stopped beating and he wasn't even breathing. The doctor pronounced him at a few minutes after 3am.

How can someone be talking to you and then dead the next minute? He was old, in his 80s and had COPD...beyond that, he should have been fine. The family is not going to do an autopsy, so I'll never know what happened but always have questions.

This isn't the first time that my patient died, it's just the first time that it was so unexpected and random. I was the last person that he saw before he passed. I was the last person he spoke to. I'm still shell shocked. The nurses on the unit accepted it cynically, and almost without empathy. I'm dealing with hella emotions at this point, feeling that if I had stayed in the room for just a few more minutes I could have helped him live.

The next night I had a patient in the SAME ROOM. Unfortunately he didn't get much sleep that night because I kept going in to make sure he was still alive. I checked on him almost religiously, freakishly paranoid that this old 80 year old would die on me too.

How do nurses deal with all these emotions? I don't know what to do.


raecatherine said...

you just started working at a new place and already had a death? that is really tough. i'm sadly lacking in cardiology know-how...but maybe if you are questioning what could have been done for this patient, reviewing his case with like, a clinical nurse specialist or other supportive staff might be helpful. it's never easy when a patient dies, i feel fo you.

NocturnalRN said...

I hate when it is a shocker. My first code was like that. At least they went quickly. I mean with COPD you can suffer for a long time.

Bobby, nottheliver said...

I'm sorry.

Ruthie - just another nurse on the net said...

Having a patient die is never easy. I have worked ICU, then ER for more than a decade. It is an experience like no other.

I add a lot of humor in my blogs and when I tell shop stories to my friends and family, I always pick the funny and interesting ones. The sad feelings and, sometimes the guilt that goes with patients who die is sometimes difficult to articulate. It's always good to have someone to discuss these feelings with, someone who actually 'listens.'

Of course, blogging is an another outlet. It's my distraction.

Enjoyed your blogspace.

Anonymous said...

I do not know if my comment is going to help you but I had the same experience like you with my adorable mother.She pass a go many years, and I saw her death. It is kind of experience I coudn't forget,for many years I asked by myself about my mother death and only JesusCristh was able to help in many diferrents way, and He still helps me. Doesn't matter who is going to die in your arms or in front of you, you heart is going to teach you how doyou need to do the right things even the person is you relative or not.
Try to surpass this shock and be ready to continue do the beautiful and amazing way as a nurse.I will pray for you and remenber you did the right way and be glad to help people like that older man.

Anonymous said...

Hey there... You should realise nothing would have changed whether you were in the room or not - it's part of life unfortunately...

It's difficult to say, but sometimes the best way to not retain bad memories of people who die at work, is to remain detatched as much as possible... leave the bad stuff at the door when you go home, so to speak..

Good luck with your career, I've been nursing 8 years and still some things surprise me ;)

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