My co-worker, giving me advice on letting the little things go and not beating myself up for the things undoable during a crazy shift where I was tripled (including one patient who should have been a 1:1). (via chartingnewterritory)
Relinquishing control; always a battle with perspective of what we think we can, and what we should.
i-dont-even-care-wolf asked: I just had my first patient code and die on me last week and I don't think I'm dealing with it. Any advice?
Losing a patient unexpectedly is never easy to deal with. If it’s an expected, serene passing, you have time to prepare. But in a code-setting, there’s all the adrenaline and the tension, followed by that sense of defeat and sometimes failure. It’s so difficult to deal with because when we set out to become urses, we wanted to save everybody. But we can’t and that’s a fact of life we need to accept.
Losing someone doesn’t mean you’ve failed as a nurse! It is so important that you remember that! All the good you have done and will do isn’t cancelled out by a death. Like I said before: sometimes, eventhough we try our very best, we lose someone. There is always a part of the situation that we cannot control. Sometimes, a sepsis becomes worse eventhough the patient is receiving the correct treatment. Sometimes embolisms happen despite our best efforts, proven to be effective, to prevent them. Sometimes, our efforts just aren’t strong enough to deal with the whims of nature. Sometimes, we miss something because we are just so busy. We are only human.
Personally, I have a little ritual for when I lose a patient. I come home and light a candle I only use for times like these. I take as much time as I feel I need to think about what happened. Perhaps you can find something similar, something that works for you. a private moment to mark their passing and give yourself some closure.
It is so important to talk to people about this. Look for support from your loved ones. It’s not always easy to find if they’re not health care providers. Sometimes people are scared to talk about death, or are a little intimidated by the harshness of these situations. So talking to them about what happened may not always be easy. For me, whenever I’m having trouble dealing with certain events at work, I turn to family and friends for distraction. Call a friend and go do something that relaxes you. Go for a run, do some yoga, have a movienight,… Whatever it is you guys normally do.
And just as important: talk to your team. Some units have a debriefing after every event, be it a death, an accident or any other major event. It allows you to express yourself and look for support from people who were there with you, who can relate to what you feel. Look back at the situation, reconstruct it: what happened? Did everything go as it should have gone? What where the positive aspects of the response, what aspects need improving? If situations like these arise again, will you deal with them in the same way, or should something be adapted? If you’re team doesn’t have these debriefings, ask to sit down with any staff that was present: other nurses, the charge nurse, the doctor. Tell them what’s on your mind, what’s troubling you. They’ve been through what you’re going through, they can help.
It can help to take your grief, your anger, your frustration and use that energy as a positive force in your nursing. Show yourself just how good a nurse you are. Do your very best and you’ll see that the loss of a patient doesn’t mean your skills are lacking. You are still as good a nurse as you were before, sometimes you just need to remind yoursef of that.
Losing someone never really gets easier. But you learn to manage it, you learn to set it in a context that shows you that you did what you could. I’ve been a nurse for 4 years now. I’ve lost quite a lot of patients, both expectedly and very sudden, old, young,… Sometimes I still have trouble dealing, but I have found ways to get closure. You’ll get there too.
Hang in there. <3
Really good advice about learning, or moving towards, acceptance of losing a patient in a Code situation. We don’t always give ourselves the acknowledgement and personalize some “fault” that must be ours.
(from an email that my husband sent me, on a particularly rough day.)
“Of course I won’t laugh,” said the nurse. I’m a professional. In over twenty years I’ve never laughed at a patient.
Feeling very badly that she had laughed at the man’s part, she composed herself as well as she could.
"It’s swollen," Bob replied.
She ran out of the room.