She didn’t know her words would haunt me for years to come. It was a night like any other night. I stood at the bedside of a relatively stable patient, and I was dutifully giving him his meds. The floor was quiet, patients and nurses preparing for the night shift a few hours away.
Like a fire klaxon, a voice cut through the relative peace of the hospital floor. “My husband is dying! My husband is dying!”
Instinctively, I dropped the medicines and darted out of the room. In the middle of the hall, a middle-aged woman ran toward me, screaming about her husband in the room across the hall. “He’s dying,” she yelled into my face.
Mouth dry, heart pounding, I pushed past her and entered the patient’s room. Of course, he was unconscious, blue, and not breathing. I started CPR, but the craziness was not over.
I wasn’t exactly a new nurse. I had been through a few codes, and they all went rather smoothly. I never experienced the stomach-churning nausea of having a family member witness their loved one dying.
The patient wasn’t mine, but I knew about him. He had recently had coronary artery bypass grafting surgery and was due to be transferred to the ICU any minute because his heart rate and rhythm were abnormal. His doctor was on the floor, writing the paperwork for the transfer.
Others had heard the wife call out in anguish, and everyone came running, including the doctor. He burst into the room, shouting, “I need an intubation kit! Get me an intubation kit!”
I could hear the rumble of the crash cart coming down the hall, but it hadn’t quite reached the room yet. The doctor continued to yell at me, to point, to spit. His hands shook, but I had been here before. I yelled back, “Hold on a second! It’s coming!”
I realized then that the doctor was more afraid than I was. The cart arrived, the patient continued to code, and the doctor got his intubation equipment. Although we managed to get a sustainable rhythm on the patient, he soon died in the ICU.
Of all the codes I experienced over my years as a nurse, this one sticks out as the most horrible. When codes start, nurses become the ultimate professionals. No one runs. No one yells. Everyone works as a team.
As a relatively new nurse, I never experienced the terror that “normal” people experience when someone starts to die. For me, I knew how to handle it. A patient going south deserves my close care, but the emotion is usually not high during care involving advanced cardiovascular life support. Afterward, I would cry and shake, but not when I needed my faculties about me to do everything I could to save a life.
This code was different. In fact, I can live it over and over in my mind, and I still feel as scared now as I did then. The wife and the doctor were breaking the rules. They didn’t know how to deal with death, and I don’t really blame them. I just know their actions scarred me deeply.
Trauma is a real problem in nursing, and situations like these can cause a nurse to relive moments that didn’t go well. This is especially true of new nurses. New nurses make mistakes, and they haven’t developed the ability to be the calm professional yet. This means that the trauma of extraordinary events can stay with them forever.
I never dreamed that I would face a family member who was screaming that her husband was dying. I can only imagine the torment she was going through, the heartbreak of knowing that her loved one was slipping away before her eyes. She reached out for the only help she could.
And that help was me.
Her terror has stayed with me all of these years. In that moment, I became her. I empathized with her, as any good nurse will do. I felt her sorrow, and despite our best efforts, we couldn’t save her husband. I find myself imagining how she felt when he actually passed away.
I will admit that this situation scared me, and I have dwelt on it more than I should. Nurses, especially new nurses, have to develop a sense of detachment from the patient and family. But what about the human side of the equation? Too much distance leads to too little caring.
I am happy to say that I took part in codes after this one, and I did the best job I could. In fact, I was praised for my work in situations where a life was on the line. But I never forgot the distraught woman in the hallway, or the surreal feeling of dread that her words—”He’s dying!”—caused in me.
It remains a trauma that has impacted my life forever. Nurses need to realize that they experience traumas, too, and that it is okay to talk about them. It is okay to be afraid. It is okay to reflect on the situation and examine the emotions the trauma awakens. Without this reflection, the emotions become buried. Ignored emotions manifest as substance abuse, out-of-control feelings, and hatred of the job.
My trauma is just one example. Almost every nurse has a story of when she or he was scared and traumatized. Talk about it. Don’t pretend to be so strong that you don’t need to ask for help.
I wish I could have saved that man. I wish I could have wrapped that wife up in my arms and made it easier for her. I couldn’t, but it will stay with me forever as the trauma in my career that haunts me, because I couldn’t hide behind the façade of the calm professional.
I am the calm professional, but I am human, too.
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My field, psychology, has not adequately dealt with the problems of how
to maintain an equilibrium in the face of unknown factors like the trifecta you experienced.
My clinical experience began as a child psychiatry postdoc. I was a research psychologist, and I had no preparation or expectation for the life-changing or death issues I encountered. One of my early cases displayed the potential for horrendously callous disregard when a medical professional becomes hardened to patient realities. A teen had just then been abandoned to us by his aunt and uncle when he was diagnosed with a brain cancer recurrence. We were stunned by the cruelty of his diagnosis and his family. Our chief resident admonished us, in his presence, “Suck it up, you have other cases to deal with. YOU aren’t dying!” I vowed to never go to that cold inhuman place she had arrived at. But I didn’t know HOW.
That was so intense. I can’t imagine what you or the patient’s wife went through at that time. I know it must be a norm to be rushed to dying patients when you are a nurse but how do you get used to that. How do you ever get used to something like that.
So much respect for all the healthcare professionals especially nurses who have to go through this ordeal on a regular basis. Anyone would just have a break down but you guys keep going. Commendable!