« Low ICU Morale | Main | Going Home »
July 30, 2007
10 Deaths and Counting
Beka - Last week was a horrible week in the ICU - 10 patient deaths, and 2 were completely unexpected. I felt sad, miserable, and distressed as the count kept increasing each day, with our deaths soon replaced by newly admitted patients. Many of the patients who died had developed long-term relationships with us during their complicated stays.
First there was K, who was always waving to us as we rushed passed her room. I also think about M, who hated to be turned until we ordered a Clinitron bed for him. Patient C had come a long way from having an open chest and two cardiac arrests after his heart transplant. Then there was R, who would play with his sheets all night long until we realized that he generally slept without any sheets. Nude!! Patient B had just given birth to her second child and would never being able to bond with him. Patient A who had an autoimmune skin process, yet tolerated painful skin dressing changes without a complaint, while peeling skin covered her bed. There was V, a CNN news devotee, who would inform us of the latest daily events during bed baths.
Yes, it’s been a horrible week in the ICU, a week filled with death and dying. Obviously the dying process is unique to each individual. The actual date or time of death is unpredictable. And I wonder how prepared each nurse was when we suddenly needed to provide morgue care and affix that last name tag, tied to a single toe. Some of our most talkative nurses became less so last week. We were not immune to the effects of death. I must admit that I began having increased day dreams and/or night dreams of my own deceased family members.
Many staff exhibited other symptoms -- an increase in the number of sick calls, and complaints of fatigue, frequent headaches, and digestive concerns. We had no staff bereavement support group. Maybe it is time we began one?
There is no way to determine how long our state of bereavement will last. It could last for just a few short days, or months, or it may last for a number of years. Everyone in ICU experiences bereavement and the grief journey differently, just as we all find unique ways to mourn all our losses. Sigh… What does your staff do to cope when the losses seem overwhelming?
July 30, 2007 in Beka | Permalink
Comments
Since I work on an medical/oncology floor that has palliative care patients I have some experience with death. It does not get easier, even if everyone is expecting the outcome of death. When one of your other patients code, the suddenness of being alive one minute and the next they are gone is still shocking and difficult to deal with. And you must take care of the other 5 patients that are depending upon you to give them the best care you can. We have been especially hit hard this past week when one our own nurses took her life after an especially stressful day. I feel that management does not comprehend the stress a nurse has when she is a charge nurse taking a full load of patients and is the resource nurse for several "new" nurses. We are all wondering if there was something we missed or could we have done anything to change the outcome of someone so young. In the end everyone must cross that bridge alone, whether it is expected or sudden. All we as nurses can hope to do is help make that journey as easily as possible. Perhaps a kind word, or a pat on the back for everyone we have contact with may make a difference for someone. For are't we all making that journey?
Posted by: Karen | Aug 9, 2007 11:44:33 PM
Oh, this is a hard one. I suppose kicking up the radio won't cut it, right? In my job it's also very difficult not getting emotionally attached to people, but there is a certain attachment place in the brain, I think, that has to be reeled in a little, and those of us who survive people work do that.
Everyone else goes into real estate.
But death? The sheer trauma and finality is so sobering, so sad. We humans value life. I'll tell you what Goering told the Nazi soldiers who complained about killing people. He said that if you do it often enough, you get used to it. But then he ordered them to drink a liter and a half of vodka before Babi Yar.
There's a dissertation here somewhere.
Posted by: therapydoc | Aug 9, 2007 4:31:32 PM
I feel there should be debriefing and some sort of connection or group for this experience. After all one can not go home and talk about your day at work or loss, it just seems that noone else will understand. I am a new nurse less than one year and 2 weeks out of orientation one of my patients went into cardiac/resp arrest, the code was long, it was unexpected and the patient did not make it.
I felt guilty.
I also learned something.
I learned to listen to my patient who told me she was afraid. I told her she would be ok. She was not ok. She died.
What happened after that was that everyone on the floor felt sorry for me. Which sort of made me feel worse. I did feel comforted by the nurses who just stood by me and said they "understand" and just "knew".
Than after that....you go back to care for your other 4 or 5 patients? It was a shock for me, and a huge wake up call. This patient was stable.
So back to coping....I had time off after that shift...I was home, alone, to think about it. It was terrible. I almost wanted to go right back to work to be with other people who just "knew" what I was feeling like. I actually went through a greiving process. It was weird.
My way of coping about this particular experience can be found on my post "weepy" at my blog.
Posted by: jane | Aug 9, 2007 12:15:54 PM
Hello,
I am a new nursing student who has already witnessed the unfortunate part of a nurses job and also life's unfortunate situations, sometimes. I imagine I must learn to muster up the strength not only to carry on during a 12 hour shift after death occurs suddenly or unfortunately but to cope with some sort of method that allows nurses to sleep with a clear conscience at night. As I'm learning we as nurses first need to take care of ourselves by retreating, managing a healthy diet and just plain and simply taking care of # 1. On the other hand I dont think you can ever completely erase the tension of death... thats why we are nurses' to begin with, to save life and hurt...
Posted by: Gene | Aug 8, 2007 12:28:40 AM
