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June 04, 2008

Do You Remember Your First Patient?

Hands272x721 Her name was Alice and she was 98 years old. She had lived a long life. It was my first day of ICU orientation. Room 9 was the room where she was surrounded by her extensive family -- sons, daughters, grandchildren, nieces, and nephews. They all swarmed around the room, exchanging sit-times with her. I wondered how I was even going to get to her to assess her.

Alice was dying. DNR -- Do Not Resuscitate was the order. Morphine slowly infused into a tiny right hand vein. DNR- What was I supposed to do? As a new nurse, I had just learned ACLS and was ready to jump and give a pre-cordial thump on anyone. I knew it was going to be a long night.

I recall entering the room, introducing myself and then directly focusing on Alice. Mouth and skin care were given. The family wanted to help, in any way that they could. They helped me turn her, and a daughter gave a soothing backrub. And so, the routine began until the cardiac monitor began showing a dropping heart rate. Gently, I turned off the monitor and sat with the family holding a daughter’s hand as tears brimmed my own eyes. For eight hours I had listened to stories of Alice’s life -- of growing up in Nebraska, of meeting the love of her life, of joining the Peace Corps, of chopping wood, of her favorite flower - the rose, of cooking large Thanksgiving dinners, of vibrancy and life.

Life was now ending. A bleep from the monitor could be heard. Silencing it, I let the family sit and hold her before calling in the physician for the standard pronunciation of death. No HR, no BP, no respirations.

Yes, this was my first patient in ICU. It was eventful, emotional, and a true learning experience -- one that I will never forget. No longer am I afraid of death and dying.

Do you remember your first patient?

June 4, 2008 in Beka | Permalink

Comments

Rosie, was my first patient and my first patient to die. she was in her 80's and blind, with very little communicative abilities, but she had a smile that spoke volumes and I will never forget her. When she died, I swear I bathed her body with my tears.

Posted by: JoAnne R. | Aug 12, 2008 5:58:44 PM

That first patient was almost 30 years ago but she was just 13 yrs old and did not live to see 14. She was the first person I had ever seen with cystic fiborosis. Tiny and frail but a fighter to say the least. She took so much medication I figured she would choke. So we gave her medication slowly. She and I got to be good friends. I was only 19 yrs old myself and her family lived several miles away so could not visit often. She died while I was sitting with her late one night. Maybe that is why I love hospice. She taught me a great deal about life besides living and dying. Funny, I had not thought about her for years. Thanks for bringing out good memories.

Posted by: Denise bK | Jun 25, 2008 9:26:52 PM

50 yrs ago,as an 18yr old student, my first patient was a gentleman in his '70's who had a stroke about a week earlier. He was only minimally responsive. My first task was to give him an enema- the old fashioned kind- 3H it was called. The enema return was "explosive", and I had to return to the dorm to change my uniform. When I returned, I was told to "feed him", which I did, until he had an explosive "upchuck", soiling my uniform again. I returned from the dorm to discover that he was taking his last breath. I wasn't sure what killed him, the enema or the food. My instructor didn't know either. He could have aspirated on the food- she thought.

Posted by: MaryAnn Foley | Jun 25, 2008 4:09:05 PM

whoah..i cant remember my first patient.. i was first assigned as MS nurse... then moved to OR. my first case in OR was thyroidectomy... that time, i just hold the army navy for the whole operation.. funny.. isnt it? i was new at that time.. so the senior nurse, teaching me how and what to do in thyroidectomy..

Posted by: Caey | Jun 16, 2008 12:53:30 AM

Reading everyone writing bout their first patient I remembered mine too.I can still rememeber how we all were sacred to go to the hospital for the very first time as a student nurse and we were very excited as well as scared bout what patient we were gonna get, after the patients were divided we went to our assigned patient.I don't remember the bed number and the patient's age but she was quite old.Her diagnosis were tetanus,she looked soo sad.Each morning i gave her mouth care but that was also very difficult because her jaws were locked and afer every procedure i used to have chat wid her bout her family and how she got tetanus i cared for her for 2-3 days then i got new patient.I have come accross many patient but i still remember her and it was 3 years ago

Posted by: xena | Jun 14, 2008 8:29:15 AM

Martha Styles,( room 8, she would say each time she rang the call button) an elderly black lady was one of my first pts. It has been almost thirty years since then but still easily this sweet lady still tugs on my memory today. Ms. Styles was a lady who was dying with cancer. She maintained her dignity until her death always crediting Christ as Savior. What a comforting verse that says, Precious in the sight of the Lord is the death of a saint.

Posted by: Tammy | Jun 14, 2008 12:05:46 AM

It was the first day of my first rotation as a nursing student. My first patient was a 97 year old gentleman named Vinyl. He was unresponsive and had gas gangrenne of his feet. I entered the room in my clean and creased new uniform with brillantly white shoes ready to minister to the sick and somehow help save the world. I left with the smell of the gas gangrenne in my nose that stayed with me in the following days of lectures and labs. It dawned on me that I had no idea what nursing was all about and what I was getting myself into. Thirty two years later I know that I was right, that I didn't have a clue as to what I was getting into. But I am here to tell you that even though at times it was difficult, challanging and gut wrentching, I have not had a moment's regret.

Posted by: Jan | Jun 13, 2008 6:30:26 PM

I was surprised to admit, upon reading the stories here, that I could NOT remember my very first patient, partly because I was an aide before I was an RN, and getting the two "first's" confused. I do recall my first patient dying. I was 18 and an aide, and no CPR was done. I remember being so alarmed ,as the RN in charge tried to soothe him, and give oxygen as he turned blue then grey.Afterward, I kept sneaking in to peek at him while we waitied for the funeral home. I also remember my first such experience when I was the charge nurse. I had been giving terminal care to this very sweet man, and his family for several days, and when my shift ended, I resisted going home. When I returned two days later, and his bed was empty, I was pained. What I remember most about that day, was that no one wanted to talk about it. The other staff behaved as though they'd already forgotten the man. That was a shock to me too

Posted by: norma, RN | Jun 13, 2008 2:18:11 PM

Yeah I remember my first day as a qualified RN fresh out of uni. I walked into a 4 bedded room and I remember one man in particular as he was there for weeks and was an amputee, diabetic and heavy smoker.The man wieghed 40kilos at most and he spoke no English (was Vietnamese)despite living in Australia most of his life as a pearl diver. He would always say "No worries" even when he was in pain. He ended up leaving us for rehab but I can still remember his smile (5years ago). I am still very affected by all the ICU patients Ive cared for esp those that didnt make it and their families!! Many tears Ive shed.

Posted by: Kay | Jun 12, 2008 5:16:47 AM

My first patient was 18 y.o. with a severed spinal cord. C-2 fracture from diving into a swimming pool at a party. After weeks on a ventilator, the day I had him, he made the conscious decision to take himself off the ventilator. I'm not sure who cried more, his family or me. That was 32 years ago and it seems like yesterday.

Posted by: jeani | Jun 11, 2008 11:34:31 PM

In 1985 as an 18 year old student the first patient I ever showered died as I was putting him back to bed. He was old with various medical problems and was NFR. I remember thinking "Oh I hope I didn't cause that!" I told the RN who was working with me and she reassured me that I had not contributed to his death. I was not shocked or upset by his death, but I use to think that 18.5 years was too young to witness death. I have been specialising in palliative care since 1996 and have become so comfortabe with death that I now think it is never too young for people to witness what can be a beautiful event.

Posted by: Adam | Jun 11, 2008 11:02:51 PM

I remember my first patient as a student. She was a 91 year old lady with dementia and had bed sores. I was told that she no longer spoke English but she really did. She was able to say basic things but understood and responded. It made me learn that no matter what remember there is always a person there not just a disease or a shell. All people needed to be treated as people not as the disease or treatment they recieve.

Posted by: Laurel | Jun 11, 2008 11:00:54 PM

My first patient as a student nurse was a young married man with 2 small children and a diagnosis of pancreatic ca. As I gave him a back rub I found myself visualizing the soft, young skin with earth dropping gently on it - an unrealistic view but one as clear as it was that day many, many years ago. Even with many years as a Critical Care Nurse in a busy ICU and now retired;it still has the power to move me as much as it did on that day. Thank you so much for the opportunity to share with colleagues.

Posted by: barbara | Jun 11, 2008 9:51:27 PM

Yes !!!!!!
In 1969 , my first patient as a 18 yr old nursing student was a 20 yr old male have nose surgery who I had to do "foot care" on. I needed to soak his feet,massage them and lotion them ,even though he was having NOSE surgery !!!!!! How very embarrassing for a 18 year old GIRL. !!!!!
Of course I fell in love with him. !!!!!!

Posted by: Bety | Jun 11, 2008 4:17:20 PM

My first patient as a student (in 1957) was an older woman. As we had been carefully taught to do before breakfast, I got her a basin and washrag and washed her face and then gave her some mouthwash to rinse out her mouth. She swallowed the mouthwash. I thought I had killed her. Of course I had not, but it was a startling experience to say the least! However, I continued on as a nurse and nurse educator for the next 42 years and loved every minute of it.

Posted by: Priscilla | Jun 11, 2008 1:31:45 PM

My first patient was a full arrest just as I walked into the room to complete my first assessment. Talk about combat nursing at its finest hour. My preceptor left the unit to get coffee and I wanted to crawl under the bed. Thank god that I had been well trained enough to find the code button on the wall and where the bag was and to start CPR. I think I would have lost it if my mother had not been a CPR instructor and I was not her helper for many years that it all came in naturally. She didn't make it but I still am working on it after 15 years.

Posted by: Pat S | Jun 11, 2008 1:34:45 AM

an elderly lady, late 90's, last few days of her life, could no longer talk but could scribble words on paper. The only thing she could eat was jelly. She would write it every time I went in her room. I made her laugh and she was always happy to see me. I can close my eyes and see her now. That was in 1965 and the cost of the semi private room that she was in was $9.00. I am still a nurse, 43 years later. Still, I remember her and her pleasant attitude while facing her last few days.

Posted by: Sherry | Jun 11, 2008 1:24:41 AM

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