Three in one shift?
That would make even the crustiest old bat have a bit of a heartache.
Dang. I’m sorry.
But in general, every death, much like every patient, is different. I have witnessed “good deaths” involving Morphine drips or DNRs quietly passing while appearing to be sleeping peacefully.
I’ve also seen UGLY, NASTY deaths involving multiple codes in one night. Traumatic pneumothoraces, blood coming out of ETTs, families weeping at the bedside.
I think this is one factor in our caregiver grief.
Another factor is…how *deserved* was this death? I’m not saying we put prices on our patients, but everyone reading this knows exactly what I mean.
The last patient for whom I personally performed post-mortem care was a known child molester.
A patient who died close in time to that person was a chronic, well-loved patient. Many staff members, some from other units, came to pay their respects to this gentle soul as care was withdrawn. Tears were shed that night - but none were for MY patient.
And then we have age.
I recently had a patient younger than I am who died. She had three small children and I said to myself, “she didn’t even have a CHANCE at life. She won’t get to see those precious babies grow into adults.” (How pediatric nurses do it…well, that I don’t know).
On the other hand, a 90 year old great grandfather who saw it all, did it all, left a legacy of love…he “led a good life.” It’s our way of saying it’s okay that he died.
I’ve noticed that the way we react to patient death is also related to how close to death we work. As an ICU nurse, I feel like the grim reaper at times. My ED friends see numerous deaths rolling in all at once sometimes. But Labor & Delivery nurses - their patients’ deaths are ALWAYS tragic. ALWAYS. They’re rare (I hope) and memorable. When I worked in ambulatory surgery, we had one patient die. One. We all remember her. Most of us probably still recall her name. Everyone can describe the circumstances in great detail, even years later. We all were shaken.
But the most important factor in handling caregiver grief, in my opinion, is our relationship to said patient. I’ve had patients that have touched me, that I’ve connected with, that I’ve developed a rapport with families, etc. Those patients’ deaths hit me a lot harder than the patients who were already hospice care when I arrived on shift. I didn’t know them. I made sure their morphine doses were adequate, the family was supported, but I probably didn’t cry.
Those are my beliefs related to a nurse and the deaths of her patients. I don’t have much advice for dealing with it, or shutting off when you get home. But I’ll say a few quick things…
- Don’t shut off. Acknowledge your grief. Let your family know why you’re sad. Cry if you need to.
- Read the patient’s obituary. It helps to personify him or her as a healthy person and see why perhaps he or she IS at peace because you can visualize him or her ill
- Pass it on. Read what things your patient enjoyed, what causes were important to him or her, what he or she maybe never did get to do due to illness. And do something that will benefit society, yourself and your patient’s memory.
Again, I’m very sorry to hear of your awful shift. My condolences. I can tell that you are a caring nurse and your patients were certainly fortunate to have you during their final moments.
I’d like to say it gets easier, but because of those factors I described, it doesn’t for every patient or for every nurse. But you MUST acknowledge and deal with your grief. Consider decompressing with other staff members who knew the circumstances of the deaths…they’re probably feeling similarly.