First love. First kiss. First “F” on a test. First girlfriend/boyfriend. First friend. First heartbreak. First apartment. First…..
You’ll never forget many of your “firsts”, will you? Me either. Sometimes they’re good, sometimes you’d rather not remember. Well, I’ve had a lot of “firsts” in my nursing career. Granted, I’ve only been at it about two years, but it doesn’t change the fact that some of these things are no longer “firsts”.
A little while ago, I had my first patient death, on my watch. I’ve watched people die during a cardiac arrest or if they were gradually dying, but this was different. This was my patient who passed away. This death was not expected. I don’t tell many nursing stories, mainly based on the fact I’m still accumulating them. But, I will never forget this first. In the spirit of nurses’ week, I want to make sure people know that my job is not always a funny, or scary, or stressful job, although it is all of those things. It is sometimes a very tragic job. I am around sick people all day long, and I can’t escape the fact that people do die in hospitals. Despite all of the modern technology and dedicated professionals ready to save a life at all hours of the day, sometimes it’s just not enough.
“What did I miss?” was the first horrible thought that came to my mind. “Did I do something wrong? Did I not do something well enough?”
I know now that no, it wasn’t my fault. No, I didn’t miss anything. That’s the stress of the job talking, wondering if I contributed to this awful event. Actually, I did everything I was supposed to, and it still happened. We were ready to transfer this patient to another bed, and as I was getting things in order, I heard someone in the room ask, “Is he breathing?”
My. Heart. Stopped.
I immediately straightened up, looked at my patient and realized that no, he wasn’t breathing. I quickly felt for a pulse and called my patient’s name, willing him to wake up, as the rest of the silent room looked on in shock. I was just talking to him twenty minutes ago! How did this happen!? My brain wouldn’t work; I felt no sign of life. The people in the room looked at me for instructions. Maybe they were looking for answers.
I somehow snapped out of it and looked at the person standing closest to the code blue button. “Call a code,” I heard my voice command as I began to mentally prepare for chest compressions. And then I stopped short, realizing that my patient had a “do not resuscitate” order. I held out my hand as to stop the person – “Wait! Don’t push the button, he’s a DNR.” I took my stethoscope off from around my neck, listened for a heartbeat, and watched for any sign of respirations. There were none.
The room was silent. The color had drained from my face. Luckily, the doctor was sitting outside at the nurses’ station. Time of death was pronounced. The people in the room started asking me questions, of what I wanted them to do. I just stood there and looked at my patient for a second, and then I began answering questions and putting things in motion. I had to keep moving.
On the phone with my charge nurse, she asked, “Have you notified his wife?” No, I hadn’t. “Well, call and let her know, or call the nursing house supervisor and have her call. Here’s her extension…”
As all of this activity happened around me, I excused myself for a moment and went to the break room. I talked to the nursing house supervisor and asked her to call his family, straining to keep my voice level. I didn’t think I could hold it together on the phone. I locked the bathroom door and finally let my tears fall. I raggedly breathed for a few minutes, trying to compose myself. After a minute, I wiped my tears, took a deep breath, glanced in the mirror, and walked back out into the fray to take care of matters, my tears still threatening to unleash.
Later that night, I asked one of our more seasoned nurses as she was sitting next to me and helping with documentation, “Does it ever get easier? You know, calling the family? I couldn’t do it.” She told me that she still has trouble with it, after years of experience.
I got into my car and drove home numbly. The minute I walked into the door, my tears came back full force. I will never forget the look on his wife’s face as she walked onto the unit. I will never understand how I didn’t break down in tears when she walked in, but I just gave her a hug and told her how sorry I was for her loss. I will never forget how I felt instant panic but kept myself together and was calm on the outside, ready to take action. My patient did have a DNR order, but it was incredibly hard to do nothing to save him. It was crazy that my training hard-wired me to “call a code” and that I was so ready to take action that I had to stop and remember that my patient didn’t want all of those life-saving measures.
Nurses do not have the most glamorous jobs. You hurt, we hurt with you. Patients will always come and go, but there are some “firsts” that stick with us, and some “hundredths” that stick with us. And we are so ready to do everything we can to save lives. I am so thankful for the team of nurses and healthcare workers that were with me that day. And, I’m not ashamed of those tears that I cried – in the break room or when I got home. I’m only human. It is a huge honor to be a nurse and have people trust me with their lives.
“He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away.”