…and I feel…well, not much. The code was interesting, in an academic kind of way, but I left the very crowded room to the folks who know more. I spent the duration of the code in the hallway with the patient’s daughter, who stepped off the elevator to visit with her mom literally as the code started. She was numb, and in shock, and I just held her hand and made as much eye contact as she could stand. Answered her questions about what was going on as best I could. The hospital chaplain came up when the code started, but let me be the “point of contact”, as it were, since it seemed to be working for the daughter. I got her some water and some tissues as the shock turned to tears.
20 minutes into it, and the daughter asked me if they could stop. I told the RN supervisor, who relayed the message to the Code Team, and they stopped the code.
She kept holding my hand as we walked into the room, where she finally let go of me and hugged her mom and started crying and said goodbye. The chaplain thanked me, and gave me the quiet signal to get lost. Later, she checked in on me, thanked me, and told me I did everything right.
I feel like I should feel more. The patient was talking and getting up and around earlier in the day and now she’s…not. The rest of the staff quickly got back to business as normal, so I followed suit and took 11:00 vitals on my other patient.
Having been on the other side of the equation (the distraught relative) I think you did exactly the right thing, offered the proper comforts, allowed the person to express their emotions adequately, and in every way did the right thing.
You know, I don’t expect medical personal to react as I do to the death of someone close to me. I am well aware that they don’t know my loved one as I do, that they can’t react with full blown grief to every death and continue to function, and yes, I do expect them to care for me on some level (as you did for that woman). I want you, the medical professional, to remain calm, cool, collected, and even a little detached.
You’re in a different relationship with death than you were before you were in your current role. That’s why it feels so odd. But you’re OK, really you are. If you’re not feeling grief or sadness, well, you’re feeling professional which is as it should be. Doesn’t mean you’re calloused or unfeeling, it’s just that your in a different place that most of the rest of us. We need you to be that way, in fact, that is part of your role.
So, um, good job in a difficult situation. I hope you will not face this too often in your career.
I lost both of my grandmothers rather suddenly, back to back this winter–one the day after Christmas, the other the first week of February. Both were in the same hospital, same unit, same nurses. From about the second week of December until the first week of February, we were there every day, and got to know the nurses.
The night mom’s mom died, the young nurse was so comforting. She’d just lost her grandfather, and my grandmother was only her second or third patient to die. She’d just lost her grandfather the week before. It was the day after Christmas. We were as prepared as you can be for such an event, which made it “easier” but still, obviously, difficult. She hugged us all and had a good cry right along with us. It didn’t seem inappropriate, or unprofessional, at all, to us. She got to know my grandmother and was genuinely sad as well. She was on the same night my other grandmother died, as well (the poor thing) and just having her there was a comfort as well. As much as I know you need to be detached, it’s so important to not let that make you cold and hardened, and the nurses we had both times were wonderful. As you showed yourself to be here.
Thank you. I hope so. My one regret is I didn’t say goodbye to the daughter when it was time to go. I stopped outside the room, and she was crying on the phone, explaining to someone what had happened. It seemed callous to interrupt her to say goodbye, but now I’m questioning if I should have called someone else to pick my daughter up from school and just stayed late. OTOH, there were plenty of people there to support her at that point, and I’m probably fading in her memory as just “that nice nursing student” by now.
THANK YOU! Yes, that’s exactly it. “Death” means sadness and loss and grief and all that. Only now, that’s not mine. That belongs to the family, not to me. And that’s okay. But it’s going to be weird for a bit. Thank you for articulating that, because I was stumbling there.
Thank you, too. And absolutely, you’re right. If I ever become one of those “cold and hardened” nurses, I want someone to slap me and tell me to get a different job. Of course, I don’t want to fall apart at work, but if I care for a patient for more than a few hours and form a sympathetic bond, I won’t hide my tears, either. In this case, I only worked with the woman for 6 hours, and so I didn’t feel emotional grief and wasn’t about to fake it, but I certainly felt sympathy for her daughter and expressed it in word and deed, and I think that’s appropriate.
Perhaps it’s healthy detachment? If so, it’s a good habit to acquire. Becomes a bit of a juggle between one’s work life and other life.
Still, when developed, it’s a real job saver. There’s a tricky balance between feeling you are losing your sense of humanity and grief getting in the way of your job life.
Hope you have a group of working friends you can sneak off with and have a little talk and cuppa about what just happened. It will make a difference.
There’s a long list of deceased patients in my work history due to the nature of the beast and I remember well the ways the staff would react. Some became angry and difficult to work with. Some shut down. For some it becomes a habit of feeling failure and that can be overwhelming to your self-esteem and sense of competence. It also bleeds over onto friends and family.
I always try to remember that death is where we’re all going and is a natural fact of life. We do the best we can with the tools we have and the circumstances at the moment to cope with it.
We need time to process. Numbness is often the first reaction to death. And we all need self-forgiveness for however we meet it.
Thoughts of you as you begin this difficult and worthwhile path.
Forgive my utter ignorance, but is “code” a synonym for resucitation efforts? Is that what “stopping the code” in the OP means?
WhyNot, you did everything right. You really did. Please stop beating yourself up for not saying goodbye to her. Frankly, if I were in her position and on the phone on top of it, I wouldn’t want you to. If I found out you’d stayed late and rearranged child care pickup just to say goodbye to me, I’d be kinda creeped out, to be honest.
Quite likely. For what it’s worth, I think you did the right thing by not interrupting. It’s hard when you’re struggling for perfection, but sometimes it’s enough to do your best and make your best judgment call at the time and not dwell on it too much.
My great-grandfathers were gravediggers, my grandparents were funeral directors, and my sister is an assistant director of a hospice. In my family the “different relationship to death” is a familiar part of of life.
Sometimes, injuries or death will affect you greatly - when my sister was in medical school she handled most things just fine, but the evening they brought in a young man about the same age as her own son who had been dismembered by a train she had to excuse herself and have a good cry. And she’s sad when her patients die - remember, she works in a hospice, ALL of her patients die. Sometimes it will affect you more than others. Don’t over-analyse this. You feel how you feel. It’s normal that some deaths will bother you more than others. In other cases it will just be… interesting for lack of a better word.
Your instincts in these matters seem good. Your doubts, fears, and concerns are all perfectly normal. Be sure to care for yourself, communicate when you need to with colleagues or other appropriate people, and keep doing a tough job well. We need good nurses. Sounds like you’re one of them.
Yes. A Code Blue is hospital speak for “this person isn’t breathing, everyone who can should stop what they’re doing and come help”. When I called for help (“Called a Code Blue”), she wasn’t breathing, but her heart was still beating. While they were placing a breathing tube (“intubating”), her heart stopped, and then efforts were focused on trying to restart her heart with drugs and shocks. “Stopping the Code” means they stopped trying to make her heart beat again.
Yeah, the more I think on it, saying goodbye was a selfish impulse, given the circumstances, and I’m glad I didn’t go to extreme measures to do it. Stopping by to see if it was appropriate and deciding it wasn’t was enough.
If I had been working with the patient/family over a number of days or weeks, it might be different, of course.
Yes, absolutely. My grandmother fell and spent the night on her bathroom floor a couple of years ago. She spent most of the next month in the hospital, always two to three days from being allowed to go “home”–sometimes meaning the apartment she’d lived in for the last decade (probably with more in-home care), sometimes meaning a nursing home or assisted living.
And then her older daughter (my mom) went to check on her and talk to the doctors in person. And Grandma had a stroke. And the choice was made to keep her comfortable, but not do anything drastic.
So she had another stroke and died. And all were sad, but relieved, because her suffering was over–and frankly, when I’d seen her last, a month or so before she died, much of which had formerly given her pleasure she could no longer do.
A day or two after the funeral, her children visited the hospital again, and took the nurses with whom both they and Grandma had spent the most time token gifts. And checked out the flowers from the funeral which had been delivered to the hospital by the funeral home. ( I mean, yeah, the flowers had been seen before, but this was a new setting for them).
Now, not every family is neccessarily going to give the nice nurse a second thought after an experience like that. But it may happen. Or a hug or a pat on the back might be appropriate even though the person is on the phone and crying.
But in the circumstances you describe, you did good by helping when she needed you, and disappearing later. And saying goodbye would probably have been more all about you than about her needs.
You did fine. As a nurse for over 30 years–quite a bit spent as an oncology nurse–you’ll get used to patients “expiring”. In fact, you’ll get to the point where the paperwork is more of a problem. Sorry if I sound jaded, but, ya know . . . .:rolleyes: Death is just a part of life. Bottomline–they really won’t even remember a thing about you. All they’ll remember is their loved one died. Don’t worry about it. I’d be willing to bet that anyone who says they remember the nurse that was present at their loved one’s code couldn’t begin to tell you the nurse’s name.
WhyNot, I can’t imagine your ever becoming cold or hardened. At the right time, you were true to your professional training. Now you know for sure it’s there for you. Don’t be overly concerned about what you feel or don’t feel.
When I was teaching there were many times that I had to keep things at an emotional distance. But years later I find myself grieving a little for this or that particular lost child. It doesn’t seem possible that they could have been gone thirty or forty years.
My father’s last job was as Procurement Manager in a hospital; the same hospital where he died, three years after his initial diagnosis of cancer. The doctor who diagnosed him was a friend; the doctor who manages the lab where that first biopsy was done considers Dad a mentor; the first person who got hired to work in that hospital was the Head of HR, Dad was the second one, the head nurse for the floor where he died is one of the proud single-figure hires. When he was there for what we knew to be the last time, they specifically gave him nurses and aids who weren’t friends of his, so his friends would be able to go there as “friends” and not as “medical personnel”. That lab manager has a reputation of being tougher than the nails on a castle’s door; I held her while she sniffled into a Kleenex, as several strangers took the tubes and electrodes off Dad’s body.
There will be times when it hits you; most of the time, as you said, “the pain now belongs to someone else”. It’s all right. It’s all right that someone has to be the person lowering the sheet over the face, it’s all right to be the person who has the wisdom to know when to hold someone silently and when to ask the questions that help them go on, and whenever it does hit you, it’s all right to be hurting, too.
Whynot, I think you did just fine too. Very nice, actually. And the goodbye part…that often happens in emergency situations, I think. You were a sympathetic, comforting presence to the woman’s daughter, and you saw that she was being taken care of when you left. You had already given her your gift.
If you had interrupted the phone call - or hung around afterwards - to say goodbye, it would have seemed as if you were trolling for hugs and thank-yous.
You did it right.
mmm, who once had *three *patients die (just one survived my shift :))
There are other codes for other situations, but a “code”, unqualified, ALWAYS means a “Code Blue” (or the equivalent “Code 99”, used in some locations).
You were a real comfort to that family. I just lost a cousin-in-law to cancer, and the experience was the exact opposite of what you provided to the family you posted about. Your approach would have made a difference to my family members in such a stressful time.
I hate to sound callous, but it sounds as though the EMT jaded gland is developing nicely. Unfortunately, growing one is a painful process, frought with second guesses on what you did and nightmares.
I’ve held many hands and given even more hugs. I’ve deferred to more experienced personnel many times.
I’ve had about 2 dozen patients die on me so far in the 4 years I’ve been active. Early on, I was surprised at how much the ratio of Bother Me:Not Bother Me was skewed towards not. Of those 2 dozen, maybe 3 of them affected me afterwards.
My advice: continue to let the jaded gland grow because it’s a defense mechanism for your sanity. Also never forget there may be more than one patient at a scene. The daughter was just as much one as the mother, and you did fine with her.
