(Closed) Health care bees: Clinical rotations and dying patients?

posted 5 years ago in Career
Post # 3
Member
750 posts
Busy bee
  • Wedding: December 2014

I’ve been an RN for seven months now, and it’s just starting to get a little easier (after 4 years of school, too). Since I’ve started my job we’ve had six or seven (eight or nine if you count acute patients) people die, of which one coded on the unit and three decided to go hospice. I think I’ve cried on the job three times. 

My first death was really hard, it was the sweetest, most beautiful lady, inside and out. I said goodbye to her her last treatment and she was gone a few days later. Every one since then has gotten a little easier, with the exception of the code. It’s harder when it’s that unexpected. 

I guess I’m working through this too…it’s a learning process, that’s for sure. Judging by the other nurses around me, it does get easier. It is getting easier for me, but that’s not to say it’s not hard.

I should mention I work in a specialty field that provides life-sustaining treatment, so our people aren’t exactly healthy. I think maybe that helps a little….I couldn’t cope with sick kids or abused kids.

It’s all just really sad. My breath still catches in my chest every time I hear a code blue overhead.

Post # 4
Member
750 posts
Busy bee
  • Wedding: December 2014

I just reread my post and I’m sorry, that wasn’t any help at all! I guess you can tell that it makes me sad too. 

As far as doing your job without being overly emotional….you learn. Know where your bathrooms/break rooms are and keep it in in front of the patients. Talk to your coworkers, they can be a huge source of support. Focus on what you’re doing and how what you’re doing is making a difference- If you know your patient is going to die, how  can you brighten their day with your interaction? Can you make them smile, make them comfortable, help a doctor diagnose an injury that can be corrected to keep them from being in pain? Etc. 

That’s not to say that sometimes you won’t have to excuse yourself and go sob quietly for a bit…but at least you have the positives to hold onto. 

Post # 6
Member
750 posts
Busy bee
  • Wedding: December 2014

@SouthernGirl:  I didn’t get much about the death process/how to deal with it either…I think they did one lecture on it. It’s tough, and it’s hard to talk about, which is probably why it gets avoided. But, it’s okay to be shaken up and get emotional. It’s pretty much impossible not to be.

I think what surprised me with healthcare is how complicated everything is. Sure, you may get a broken bone from a skiing accident here or a simple cut from falling down there, but more often there’s something else going on. You’ll find your people are really sick or really healthy or really psychosocially impaired in some way…I’ve found that it’s all extremes. Your really nice elderly lady patient who comes in for an x ray after a fall is found to have one or more of the following a) rapidly progressing dementia b)heart failure c)elder abuse d)depression/failure to thrive. So all of the sudden it’s not about the treatment you’re administering/diagnostic test you’re performing, it’s so much more. And then she dies on you and where do you put those feelings? 

I’m probably not making sense, I worked today and it’s probably my bedtime 🙂 Sorry if this wasn’t helpful at all!

Post # 7
Member
1186 posts
Bumble bee
  • Wedding: April 2012

Hmmm, I work with the elderly in a nursing home setting so I want to answer your question but will need to do so tomorrow. 

Post # 8
Member
2622 posts
Sugar bee
  • Wedding: November 1999

I am not in your field but my mother is a hospice volunteer and goes to many, and I mean many, of a dying patiends bedside and then their funerals.

The way she shes is is she is doing what she can to make those last days and moments easier for them. She is helping them transition and you are doing the same. You are giving them the medical care they need. Is it easy? No. But when you see your role as either helping them have more time with their family or helping them transition easier, its easier on you.

Post # 9
Member
2622 posts
Sugar bee
  • Wedding: November 1999

dbl post

Post # 10
Member
431 posts
Helper bee
  • Wedding: November 2014

I was a CNA for a while working on getting my RN. I worked in a nursing home where I thought that the nurses did NOT care for the elderly like people… I could not stand it!! Most of the elderly people in the home were very confused, crying in the hallways and trying to leave… I always tried to reason and most of the time the people were consoled and happy after I said lik e “your husband took the kids to grandmas house today.” and they would be fine! But it seemed like so many nurses were just there to do their job and not care for the peoples feeling 🙁 It REALLY hurt me… I am VERY emotional and I think i am a caring compationate person. But once people started dying around me, residents whom I just loved it HURT… Like maybe I got too attached.

Now I am not working as on my RN or doing any form of nursing, I work in a daycare where I can be a ttached to the children and hopefully not have that heart break. I do think that Nurses should always care though… It maybe a tough job but there are some people who are damn good at it!

Post # 11
Member
750 posts
Busy bee
  • Wedding: December 2014

@Roxykitten:  Working in a nursing home, I’m sure you saw how busy the RNs are…usually it’s one RN a floor, and that could be 30 patients. Just want to put it out there that what you saw may very well be a function of the work conditions. It’s tough when you have 7 meds per med pass per patient and three med passes daily and your CNAs need help turning/toileting certain patients and you have orders to take and dressing changes to do…That said, a lot of nursing is psychosocial support, and with dementia patients much of that is reorientation and distraction. “Mrs. X, I am your nurse Z, you are in ABC nursing home. Your daughter Y will be in to visit you this afternoon. Would you like to join this game of bingo?” We never lie to the patients as that can cause considerably more emotional distress. 

Post # 12
Member
3773 posts
Honey bee
  • Wedding: December 1999

I have been a nurse for 6 and a half years. Most of my career has been on outpaitent oncology giving chemo nad now for a year and a hald in a cardiac ICU. The nature of both of these jobs put me in situations regularly.

Working in oncology gave me a really different outlook on life. You come across people that are dying or really sick and their spirit will amaze you. They will ask about your children, they will still laugh and tell jokes, the human spirit is an amazing thing.

In the past month I have been present for several deaths, some expected, some after codes and there are things that will never be easy to see- a husband saying good bye to his wife of 50 years, a father of young kids passing away of a massive heart attack, but you do learn how to take something from each situtation.  You will learn to find peace in that in that difficult time you may have done something that made that difficult time easier for someone else-and most days that will be enough to get you through. Some days will still be hard and on those days you go home and hug your family a little tighter:)

 

Post # 13
Member
1856 posts
Buzzing bee
  • Wedding: March 2013

I’m not in health care now (although I’ve worked in HIV/AIDS VCT and care) but my mum has been a nurse for almost 40 years. She always told me that you do eventually come to grips with the fact that people are going to die under your care, and that all you can do is provide the best care possible and give as much care and compassion and respect that you have in you in order to help them do so with dignity. There are always going to be times when there is nothing more than that to do. Some days will be harder than others, and some cases will stick with you for life – I know there are patients my mum still remembers from her earliest days as a nurse.

My dad, on the other hand, got out of healthcare within a year after a particularly horrific case involving a child. I left the health side of what I used to do for research, but I will say that there were days that it really got to me, realising I was in a room full of people living with HIV who had limited access to ARVs. Despite going into that line of work knowing the realities of the situation, there were days I broke down in bed at night because it was awful to know what the people I worked with were up against, but my mum’s advice on care and respect and compassion made dealing with the realities of death a bit easier.

 

Post # 14
Member
431 posts
Helper bee
  • Wedding: November 2014

@Dialysate:  That is very understandable! But where I worked (very small town) we always had alot of nurses(LPN and Rns). I know that they were busy most were at the nurses station we also never even had 30 residents. My nursing teacher always said if we couldnt get them back to reality it is just better to go along distract and get their mind on something else because some are very worried and inconsoleable. Which is heartbreaking! How would you feel if you didnt know what was going on?? what if you thought that you missed your bus (like one of our residents use to do)? we would try to bring her back to reality but you couldn’t she would get so upset!! So we would tell her that her bus isnt coming today and then lets go do something else and she would feel better. our reality isnt their reality. Mind you this was durning clinicals with my intructor, I worked in that same nuring home after I got my CNA. But I believe an RN has a very tough and demanding job, my grandma was one for 59 years. 

Post # 15
Member
431 posts
Helper bee
  • Wedding: November 2014

@SouthernGirl:  I think you will do great you sound very compationate 🙂 its okay to cry or have emotion we are all human. 

Post # 16
Member
1734 posts
Bumble bee
  • Wedding: June 2012

I’m not in health care, but my BFF is in med school. They strongly encourage them to develop a relationship with a counselor, just because of all the stuff you’re talking about. Maybe this might be helpful?

Also, so much respect — I could never do what you’re doing, and it so desperately needs to be done.

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