First Patient Death

I will never forget this man for the rest of my life.

I was an intern in the the critical care unit, maybe only 6 months in. I was able to work my favorite schedule 3 12's Mon, Tues, Wed because it was still summer break. I came in for my first shift of the week and met this lovely gentleman who just wasn't tolerating outpatient HD so they admitted him to our CCU. He appeared to be one of the more well off patients, awake, independent when not hooked up to HD, good appetite, etc. His only large issues were that he had a pace maker and CKD.

I then took care of him for 6 shifts (3 week 1 and 3 week 2). When you spend 12-14 hours a day with someone you become close with them. I was just as close with his family by the end of everything. Immediately on day 1 of me being with him he took to being my "grandpa", I'm not just saying that either, he kindly called himself my work grandpa. It was adorable! He asked about my schooling, how I liked working, we talked sports, pets, about his family, what he did before he retired. All sorts of things - it was refreshing because typically I was with either a lot of alcohol detox or intubated patients. The next 2 shifts went pretty similarly he greeted me with a wide smile and a hug each morning and a drive safe and a hug each night before I left. His family would come in shifts and sit with him and chat with me as well while he had closely monitored and longer length HD. I was sad by the end of the my 3rd shift during the first week to be leaving - he was one of those patients that make you look forward to coming in each day because of their positivity despite being in an ICU. So, gave him and his son a hug, they told me to be safe driving, and that it was great meeting me. They thanked me for everything and told me that they hoped they wouldn't see me next Monday (remember it was Wednesday) because ideally that meant he was improving with HD and could be transferred.

I came back the next Monday and was shocked to see his name still on the census. I requested to have my preceptor be whoever had him because we had grown so fond of each other and worked well together. When I walked into his room that morning...he was much more fatigued, needed assistance with standing up, and not nearly as hungry. With some extra help from his son he remembered who I was from last week - but it took him a second. He was not the same guy I left the week prior. He started to get more frequent occurrences of PVCs which by day 2 & 3 turned into runs of V. Tach despite the pace maker. By day 3 he was completely bed ridden, lethargic, and physicians were saying the outlook was poor. I think I was as shocked and destroyed as the family. He was my first memorable patient in that he was just so nice and amazing AND now I had never had one of MY patients turn and have poor prognosis. Being in the CCU and having scribed in the ED I had seen and assisted in numerous codes - death wasn't new to me. But this experience was.

At the end of day 3 he was officially on hospice so that family could come and say goodbye and spend time with him before the pacer was turned off. I stood in his room hugging and crying with so many family members. They were thanking me, just saying how grateful I was there to hug them, and they just were able to let loose with emotion in my arms. It unlike any experience I had ever had before. Eventually... the time came. I remember shutting off all the monitors in the room. I remember contacting the doctor when it needed to be pronounced. I remember printing the final tele strip for documentation.I remember calling for the bereavement cart to be sent up. I remember giving the family one last hug before they left to live their brand new life. I remember giving his hand one last squeeze before zipping up the white bag. I remember walking down the halls with his cart to bring him to the morgue. I remember signing and documenting that he was there. I remember leaving that night and just sobbing my car before I could drive home. I remember thinking about how they don't teach you this in school. I remember feeling like I had grown as a future nurse and knowing that this will be something that lives with me for years to come.

I feel that while this experience was so distressing for me because it was so unexpected that for a first death I was lucky. It was peaceful. It was wanted. He didn't suffer through rounds of compressions and epi that wasn't working. He went peacefully when his body was ready. I learned that night that death isn't always a terrible thing that we must fight blindly. That night I ceased to fear death and see it as an enemy but as a natural part of life, only made unnatural by the way we approach it. I still carry those beliefs with me and they help me deal with the deaths that I have had since that time.  

It was honor being apart of that mans final weeks and moments. I will always be honored to have my "work grandpa", the experiences his being admitted to the CCU gave me, and the experiences as a human he and his family gave me. I will ever forget him and is family. They will always be apart of my nursing journey and how I grew from student to intern to nurse and take my beliefs from that day with me everywhere.