We Cry Sometimes Too

When my patient dies, I try my hardest not to cry. I try to look composed and act all professional as I deal with the paperwork and flurry of phone calls that comes with a patient expiring. Most of the time, a pool of tears threaten to spill down my eyes as I try to swallow that big ball of sadness going up and down my throat. Sometimes, a tear slips down quietly unnoticed. I quickly wipe it away.

I may have been a nurse for more than ten years and you would have thought that dealing with death and dying is all but normal for us. Yes, it comes with the job. It is part of a nurse’s world. We even studied post mortem care in nursing school. And you would have thought that four years in nursing school would prepare me for that too.

No.

If a very sick patient does not get better, death is inevitable, everyone knows that. Heck, death is a part of life itself! Easily said. But not when it is YOUR patient. Not even when that patient is a DNR (Do Not Resuscitate). Not even when hospice care is involved. What will I say to the family members? Is hugging okay? Offering tissues perhaps?

But why do I get affected that way when I do not even know this person, at least, not personally? I do not know their families, what kind of lives they have, their issues and conflicts, their hopes and dreams.

All I know is that that patient expired on my watch. Maybe, there is a feeling of guilt attached. That I was not vigilant enough. That I didn’t take care of him enough. That I didn’t do enough. Be it an expected death or not, I always, always find it hard to do THAT phone call, especially in the middle of the night. I don’t know how surgeons or physicians break bad news to patients and families. They just do it.

Of course, it is harder if it was an unexpected death or say, the patient coded (either from a respiratory or a cardiac arrest) and the code blue team (that amazing team of doctors, nurses and respiratory therapists) is busily resuscitating and has been for several minutes now, the prognosis looks dim as the patient is elderly and has a multitude of medical conditions to begin with, and we do not know for certain if the patient is going to survive being intubated and sedated with a million other IV drips going, or if he does, for how long is he going to be this way. These are ethical questions and dilemmas that we as health care providers face everyday. And when that situation arises, you, as the primary nurse taking care of that patient being coded is responsible to call the next of kin and let them know what is going on. In short, you have to ask them what they want for the patient’s best interests. If they want everything to be done, then so be it. The team will work their hardest to succeed and let the patient live another day. If the family wants enough and no more has to be done (at this point, the patient has suffered maybe more than enough), then the team stops all resuscitation efforts and let nature take its course. However, that call that you make to the family is as close to or almost exactly the same as telling them that their beloved family member has passed away. And it is never easy for me.

More often the public may see us as calloused, hardened people. We talk about the grossest things, especially when eating. We laugh about the silliest medical jokes which others may perceive as offensive. We act like we do not care at all when the truth of the matter is, we are affected deep inside to our very cores that to show emotion would mean having to break down our barriers that we have ever so carefully put up and then not being able to deal with the situation in an objective manner. Everything we do at work has a purpose.

Even crying just a little bit at that patient who just passed away.

Nursing is a tough profession. Not everyone called gets to be chosen. I am blessed to be one of them, as hard as it is.

When my patient dies, I also pray that they journey well to the next world.

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27 thoughts on “We Cry Sometimes Too

    1. There are times when I think that I could not do bedside nursing anymore. So much stress, physical and emotional, that sometimes I feel like getting away from it all and maybe do something else. Thats why whenever we can, my hubby and I travel to de-stress. Or if not, I write. Hence, this post. Thank you for your kind words! ๐Ÿ™‚

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    1. Yes I agree but when you deal with these things on almost a daily basis, it can cause unnecessary stress. Sometimes, I wish there was a button we can turn off when dealing with very difficult emotional cases. But then again that would make us robots.

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      1. At the time I had a baby and a two year old. I worked nights and then came home to happy children in the morning. My husband also supported me and it helped that maybe I was only a home health aide at the time. Having kids kept me from following through with the RN program.

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        1. You can be an RN and a mom at the same time. I have so many friends who do this and I salute them for achieving their goals. You can too! (That is, if you still want to..) But, yes having your family’s support always helps lessen the stress. Thanks for sharing! ๐Ÿ™‚

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  1. A wonderfully written glimpse into your world – but I must tell you, I’ve NEVER heard anyone say a nurse, especially one in caloused or hardened. I, and most of the people I know, think you are selfless and caring and we admire and appreciate your commitment to your patients and their families. Thank you for sharing.

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    1. I try to talk about generic nursing stuff without making it sound too clinical for everyone. And yes, some patients and families although they haven’t actually said it out loud to us, but they have already judged us as uncaring or unconcerned about their needs in so many different ways. On the other hand, most of the people do show their appreciation for what we try to do for them and every time that happens, it always makes it all worthwhile. Thank you for your sweet sweet words!

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  2. That was such a beautiful post, and great to read your perspective. We recently went through a tough time with my ma in law in Canada. From the time they put her in Palliative Care, we did not feel good about the folks who worked there. It was especially hard making that 10hr trip there towards the end, and not feeling like anybody wanted to talk or give us any info. When she passed, we did not even get a call from the Palliative Care place, but rather thru a distant relative. I documented everything during the 2 months that she was in the hospital and Palliative Care and sent a letter once she had passed. There was one nurse that went above and beyond the call of duty, and we made sure we mentioned her and the love and compassion we received from her. Your post brought back everything for me, indeed nursing is a special call, and you seem to handle it extremely well.

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    1. Death is never an easy topic. I hope your mother in law passed away in peace and pain free. That’s why I can never do hospice/palliative care. I was contemplating doing that for awhile but realized I don’t have it in me to deal with such things. I would come home crying everyday! As for how that facility treated you, there is no excuse for that, especially when it comes to grieving family members. They shouldn’t be in business then, IMO. Thank you so much for your kind words! I always love hearing feedback from you. Hope all is well. ๐Ÿ™‚

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  3. I think that everything you said is true. I worked in Intensive Care for over twenty years and saw my share of death. I said that the minute I stopped crying, stopped caring that someone had died was the day I would leave. That day didn’t come but I left anyway. Having empathy for those left behind, caring that it happened makes you a better nurse (I believe) and yes we can talk about the grossest of things over dinner but that is our way of coping with what most people don’t have to see more than a couple of times in a lifetime if that. All the best with your nursing career.

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    1. Thank you so very much for your kind words! Coming from a fellow nurse makes it so much better because you know what we go through. I don’t know how much longer I can stay at the bedside though. Nursing today is way different and so much more harder than it was before.

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