Ashley Carty is a seasoned medical professional with over 8 years of experience working at the top hospitals in Southern California, including Hoag, Saddleback Memorial, and UCSD.
Did you spend your childhood playing nurse with your stuffed animals? Listening to their heart and lungs and bandaging them up when they had a boo-boo? You’ve likely always loved making people feel better, making a career in nursing a no-brainer. What you weren’t prepared for was the gut-wrenching pain of your first patient death. The emotional toll after the loss of a patient is an experience rarely spoken about freely. Nursing school prepares us for the NCLEX and caring for patients, but what it doesn’t prepare us for is coping with the death of a patient.
Some nurses go years before they experience their first patient death; others experience it right out of nursing school. Although we would love to be prepared, there is nothing that could truly prepare us for the emotional rollercoaster of losing a patient.
A nurse yelled, “call a code” the alarm sounds, “CODE BLUE ROOM 215, CODE BLUE ROOM 215. OMG (in shock and disbelief) that’s Mr. Shaffer, how did this happen? I turned to my other patient, “I have to go” and ran down the hall. I made it just as the code team swarmed in. The bed drops, compressions start, then we pause to thrust the backboard into place and get the monitors attached. I rotate in for compressions trying to remember the training. In the midst of it all, we lost his IV. I try to focus on pushing to the metronome in my head, trying to ignore that his chest feels like floppy cardboard, a fellow drops a femoral line, and anesthesia is working on securing an airway. With each push, I was praying for any sign he was coming back. We went through the rounds of “clears,” but nothing we did was working. After an hour and eight minutes, the time of death was called at 15:06. My heart sank, my mouth went dry, and I felt like I was about to pass out. Was this real, will someone please wake me up?
It was my first code, and the first time I had lost a patient.
Whether you’re an RN, NP, Doctor, or Patient Care Technician, everyone has their way of coping with the death of a patient. What works for you may not work for others and vise-versa.
Grief affects the body physically, so it’s important to practice self-care. Getting adequate sleep, regular exercise, and eating healthy are all essential components to self-care. If we don’t care for ourselves, it can become easy to over-identify with the dying and become lost in that experience. After the death of a patient, self-care seems near impossible to accomplish. Many people self-sabotage by overindulging in food, alcohol, and marathoning tv shows. One of the best ways to avoid this is to practice mindfulness. Mindfulness is an ancient Buddhist teaching the ability to live in the present moment, without distraction.
One of the most common ways to cope with the death of a patient is to talk through it. A UCLA study revealed the positive effects of vocalizing your feelings. Reach out to a co-worker that you know has lost a patient and ask them if they could meet you for coffee or lunch. Share with them what happened, how you feel, and any underlying thoughts on the topic. For some, it’ll be speaking about how you did everything you could, other times it might be you questioning if you had just done XYZ would this still have happened? Talking with someone who has been there can provide additional support in addition to getting it off your chest. If you don’t have a co-worker you can confide in, consider reaching out to your charge nurse, director of nursing, or even a grief counselor. More often than not, trying to confide in someone outside of the medical field, such as a friend or loved one, can prove to be fruitless because they can’t relate to what you just went through.
Asking for time off after the death of a patient can prove to be problematic, depending on where you’re at with your current role. Have you been there for less than a year? Are you a seasoned veteran? Asking for time off can reflect poorly on you. Some nurse managers can understand why you might need time with loved ones rather than being thrown right back onto the floor with full responsibilities. Rather than asking for time off, set a time to meet with your supervisor and share the experience with them. More often than not, if time off is an option, this will be offered to you. If it’s not, practicing self-care and reaching out for support may prove to be the most viable option.
Taking time to reflect on the positive experiences you’ve had to date working as an RN can prove to be therapeutic when trying to cope with the death of a patient. Think back to all the great memories of happy families, the times you’ve had successful codes, and when you’ve witnessed miracles happen. Remember why you got into the medical field in the first place and how many lives you’ve saved to date. Getting wrapped up in the sadness and negativity can be easy, don’t let it suck you in. If you’re still having trouble after the above, journaling may prove to be the next best way to share your emotions. You can also reach out to online forums to share your story (make sure what you share is HIPPA Compliant).
Did you recently experience the death of a patient? What are your go-to ways of coping with death? Let us know in the comments below.
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