Recently I have had a lot of patients I have been caring for die. It is beginning to get to me. I have had more than I am use to. I also had a recent death in my family. It was an "X" of my sister. I cared for all the family involved but had to deal with personal issues of how I was really glad my sister had divorced him. I did not really like him and had to be there for nieces etc whom I loved dearly. I felt torn and like I had Gall in my mouth. Then returned to work and had two deaths in the next two days. I think I dealt with the deaths and their families well. But It was beginning to get to me with to much too close together. I did go to the bathroom and cry. How do others among us help cope with this side of our job when it just seems to gather up on us like this. Don't know if I expressed myself as well as I could but it was hard enough to write it the first time than go back and revise it. Anyone with helps for times like this??
That is sweet to share such an emotional issue. I think that how we respond to and deal with death is very personal which makes us unique. I think it is important to embrace your pain.
When I was in nursing school and giving my first IM injection, I nearly fainted. I went into the bathroom and put my head between my legs and cried. Then I cried because I was afraid I would not be able to make it through school. A very wise nursing instructor (who I never had) shared some thoughts with me. She said it might help to focus on the good things I was doing for this patient. I had to process that over time and it has helped me through some bad times.
Thanks for the input. I feel somewhat better now. I just had so many so close together and after the one in the family I began to feel picked on or something. I am better now after some days off with family and no more deaths in several days while I was working. It was just heavey on me for a few days. Thanks again...
I personally have never experience death in the work place yet. I'm a first year student. I have found it difficult with getting too attached to people. I found i get too attached and then when i comes time to leave i always end up crying. i'm very emotional.
Judyd, I replied to another one of your threads on a similar issue...death is hard to deal with. I worked in pedi onco and can say I saw my fair share of suffering. You're doing the right thing - lean on anybody and everybody you can. Often nurses feel the burden of the world on their shoulders - we are the caregivers, the ones who are supposed to be strong and help others - but don't be afraid to lean back on others.
And don't feel you are "picked" - there is a saying that death happens in threes...
I am a labor and delivery nurse. When its good, its great, but when things are bad....it cant get worse. Losing a baby is the hardest thing I have ever had to deal with. It helps to have someone to talk to. When I was a student, I say my first baby die. It killed me. I didn't cry during clinicals, but I did for 2 days after. My husband told me there was no way I could do what I do now. I have learned something......Do your best. Sometimes, that is not going to be good enough and it is out of your hands. I now am in charge of our PRIDE unit. (dealing with families that have losses). Since I cant fix it, at least I have a way to deal with it. I cry with the families, help them with funeral arrangements, and just listen to them. In return, they help me.
My family is very supportive of me and knows to just give me space after something happens till I am ready to deal with it. I cant stress enough that you need to make a good strong support system for yourself. Friends, co-workers, and family. You need them all.
I have been an RN for over 30 years now, and have experienced many, many deaths of my patients. They have died in the hospital, in the nursing home, at home in their own bed, in the isolette and even on a catwalk in the factory. Each has been unique and I have been there to experience it. During the years, the way I have felt about these deaths have changed. My first deathing experience occured when I was 16 years old and working in the local nursing home. She was an elderly Italian speaking patient whose family was very attentive. She died after visiting hours with a baby doll in her arms. She loved to rock and sing to that doll. She waited until her family had left, and I was the one to find her. She was still warm and had a smile on her face and the doll in her arms. I was fortunate to have had this type of "first" deathing experience, and I think it has influenced my favoring a Hospice type death over an ICU/CCU or Code type death. I however, never try to influence my patients or their families on what type of deathing experience they would prefer. I do my best to support them in whatever way they choose to pass over. I did spend a year working for Hospice and found that to be one of the most beautiful and awesome and emotional and difficult years of my life and I am grateful to have had the experience. For myself, I do not want to be hooked up to tubes and sustained just for the sake of sustaining unless my family needs some extra time to cope and I am heavily medicated. I would prefer to pass on peacefully as possible with the help of Hospice, and my children know this. It is reasonable to feel loss and feel it intensely. It is reasonable to cry inside and outside at loss. Go ahead and do it, get it out, talk about it, write about it and then let it go so that you can do it again for your patients and their families without giving in to the depression of it. Be healthy about grieving. Read Dr Kubler-Ross's latest autobiography about her personal experiences with loss. Do whatever it takes to become comfortable with death and the possibility of life after death. Research other cultures feeling about death and then come to your own conclusions about the deathing process and how it relates to you and to your interactions with your dying patients. As with the birth of a new life, the passing of life is just as emotional and life altering. I wish you peace.
Sometimes we as nurses are faced with many stressors in our chosen field, and facing death is indeed one of the most emotionally draining. We must deal with our own emotions as well as those of the patient, family, loved ones, etc.
We try to keep a safe distance emotionally, and try not to get too attached, but that is sometimes just too hard to do. We are human, not machines, and that is what makes us all unique and very special in our own way. If we were to function solely as payed professionals, performing a service to society, then there would be no value whatsoever in what we do, for those who need us most.
I work in an ICU, and face death on a regular basis, and the emotional burden is sometimes overwhelming. When our efforts work and the patient recovers, we cry. When our efforts fail, we cry. Either way, I am comforted to know that I was involved in the process.
Have you ever held the hand of a patient as they took their last breath? It is electric.
It is also said that there is a high incidence of divorce in the nursing/medical field, and that this high rate is often attributed to the fact that nurses get so emotionally burned out that they have little left to give to their family, and breakdown occurs... I can relate, and it is sad.
Through it all, I love my work, I love what I do, and will continue to perform as a nurse. I hope that we all continue to care, comfort, and inspire.
I have not been on for sometime and was surprised to find so much help here. This is wonderful and I thank you all. I won't stay away so long again. Thanks..
As an onco/hospice nurse I have seen much death. I had to leave the field for a while, and do office work after helping a relative through the dying process. But the hardest death was one of my fellow nurses. I reported off to her one am, the next night when I went to work she was one of our patients, admitted for severe headache, CT showed CA, emergency Sx done but just open and close due to CA too extensive. She never regained consciousness, and died that night. I couldn't get my legs to move me onto the elevator to go home next am. What else would happen?
I think it may be unfortunate on my part or a blessing I don't know, but I guess i have kind of numbed myself. Death doesn't bother me anymore. When I first started the nursing school I worked as a health care aide in a long term care facility, I had lots of people dying around me and at the time it bothered me a great deal, I have a large amount of compassion and empathy and although I hate to admit it the smallest things pull on my heart strings.
But in November of 2001 my mom and dad asked me to move home as my dad was dying of cancer (his 5th tumour it was found in his lung, he had battled cancer since 1989 undergoing operations to remove 4 brain tumours ever 3-4 years). They asked me home as they knew I had the training from school to be able to care for my father who wanted to pass away at home. I agreed and set school aside and moved home. From then till the day he died I was basically, with the help of my mom, was his primary care nurse every day from November to January. I cleaned him when he was incontinent of bowel and bladder, I did the am and pm care, mouthcare, dealt with his medications and IV, had my finger on his pulse when it took its last beat, and helped the man from the funeral home load him in a body bag and lift the stretcher into the back of his car. Not once did I shed a tear from November until the funeral directors car rolled out of the driveway, then it was so overwhelming that I cried uncontrollably for well over an afternoon. Then that was that. I cried one more time when I read his euligy at his funeral.
But since that time, when a pt. or resident has passed or I have heard of a friends relative passing, I have not felt one ounce of sadness over the death. To be honest it bugs me it just doesn't feel normal to not feel something, anything when a person passes.
I would go with your intuition--since it "bugs" you, that you don't feel anything, that may mean you haven't finished grieving, that you are "stuck" over some issue. These things have been known to come back and bite people in the emotional buttocks if not dealt with. Local hospice services have bereavement counselors that might help, and there is also the ubiquitous EAP. I never liked counseling (going through it felt like having an emotional debridement) but I learned that the alternative was worse.
I think we all have this happen at one time or another.
I'm able to vent and have a significant other in critical care also so he truely understands. If you have a close friend or collegue that would understand what you're going through...try. If you're able to vent.
Another alternative is the web sites and groups avaliable. When my spouse died, I was lost and floundering. I found great comfort and support form a web site called INDIGO...it's a site relating to loss in your life.
I just wanted to provide a quick response to your note. Long ago (more than 20 years, that's all I'll admit to) we were taught not to get emotionally involved with patients, modern schools do not teach that nonsense any longer. I think one of the strongest attributes in a great nurse is the ability to empathize and become involved in their patient's lives. To this day, I make sure I become as involved in every patient's life that I can. It helps in your assessment, in helps in your planning, and it helps your outcomes. The better you know a patient, the more likely you'll choose options that will work!
An important part that must be learned is compartmentalizing this. You must be able to leave it at work, otherwise it will lead to many negative outcomes for you. None are certain, but you'll look at burnout, or even worse, not caring and seeing patients as nothing more than tasks that need to be completed before the end of your shift.
Finally, I like all nurses and doctors I met early on in my career, did not accept dying. We often tend to provide less care to dying patients, albeit unintentionally. Justifying our actions with a thought something like..."the patients that will survive need my care more"....or "at least I can do something for that patient". After more than 20 years of nursing I took some formal training in palliative care, I cannot tell you what a profound difference in made in my care and understanding of our role as nurses. Dying is every bit as important as any other part of our life and it's something that we can all be assured lies ahead in our future. The care you provide for a dying patient can indeed be quite gratifying. One of the most important lessons I learned was that no one, let me repeat, no one should die alone. If you can do nothing else for a patient but be there and hold their hand as they take their last breath, you have provided a great comfort and level of care. It is sad to think someone could spend a lifetime at work, family, etc., and then die utterly alone. Could there be a more final statement that your life meant nothing?
Best of luck to you as you continue your training. I have and will always love nursing.
I once worked L&D. Having had an infant of my own die, I found it very hard to deal with miscarriages and stillbirths, but I found that I was more able to help the mother's and father's in my care than some of the other nurses who had not experienced such a death. All I had to do was say, "I understand, I lost a baby, too." And if I cried a little with them, that was understandable. Don't be ashamed of your tears, you are a compassionate nurse and your patients love you for it.
While a student nurse I was working at a local hospital. They called a nurses aid, and paid me as one, but I was doing total patient care, and before I had graduated from nursing school, I was charging the unit. While I was working there I got an inordinate number of death and dying patients. I came to realize that death is as beautiful as death in some circumstances. I learned to be thankful to the patients for sharing their last days with me.
After graduation I returned to working in the OR. There, thankfully, I have had fewer patients die, but there have been a few especially painful instances. One, I even went to a counselor about. I finally was able to work through my pain and anger by writing a poem about it.
I currently work in adult medical oncology. We also care for hospice overflow patients. Helping a patient and family during the dying process is not particularly hard for me, but I have been a nurse for a long time. The most stressful deaths I experience are the ones when the patient has been in numerous times, is relatively young, and you see that whole process take place; the initial stunned disbelief followed by trying to find a source for hope and clinging to that, and at some point the realization that life may soon come to an end, leaving behind all its beauty; children, grandchildren, spouses; grieving for days that have not yet come; the wedding of a granddaughter now just six years old. There is so much loss. Many times when things are over family members will tell me they don't know how we nurses do it. I try to tell them it is an honor to be allowed into such a private aspect of their lives. For myself, though I am not a religious person, I try to remember that it is better to have done something than to have feared my own feelings so much that I am powerless to do anything. Sorry if that is too long.
In reply to Andrew, this is kind of sick, I know, but also funny. We had a patient who was actively dying. She had a very hostile family. You probably know the kind; they watch everything you do with suspicion, etc. Well, along comes some estranged son who had been out of the picture for quite some time and he decides he wants a second opinion! I couldn't believe it! The woman was literally gasping her last breaths, etc. His wish was granted and the second oncologist agreed, of course, that she was terminal and only comfort measures were warranted. Still, I was stunned at the request. I actually find, in regards to physicians recommending morphine drips, that it is the physicians themselves who are reluctant to go that route. Our oncologists are quite good about preparing patients and families for the possibility of this coming up, but our medical doctors are just awful about it. More than once I have had to recommend that family members go to the ethics committee or the chief of medicine if they feel that the medical doctors will not honor their wishes.
My instructor told me a very interesting story. Forgive me if I am sketchy on some important details.
There was a woman on her unit who was brain dead (two doctors have said so) but still had some of her stem intact and functioning. She still had a pulse and breathed with the aid of a ventilator. However, most of her body was rotting away. So, as hard as it is for me to believe, she was in a limbo of life and death with very little hope for the former. She was a living, breathing corpse with a pulse.
And, according to my instructor, she smelled like it. She said that her room stank and that parts of the unit began to smell too. It was very traumatizing to see much less to deal with as a nurse.
Believe it or not, this woman is a full code. Her family believed in prayer healing and was extremely vocal and insistent on keeping her alive as long as possible. The doctors were afraid to go against their wishes even though they have full rights to turn off life support systems due to the fact that the woman is brain dead.
The nurses, including my instructor, when to the bioethics committee. The lawyers were not convinced and said that the nurses had no grounds for insisting that the woman's life support systems should be shut down. They claimed that the nurses were just "uncomfortable" about it.
So my instructor took the lawyers for a field trip to her unit. The smell hit them... and they were convinced.
