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| A
growing number of hospitals have developed small
and informal ways of helping nurses cope with occurrences
of sudden death, ranging from holding quick "debriefing
sessions" right after the death with someone
from social or psychological services to bringing
in the hospital chaplain. |
As Ginger Chichwak, RN, left her post in the adult
critical care unit at Community Hospital East in Indianapolis
for a quick lunch one day, she was confident that at
least one of her patients was in for a good afternoon.
A woman in her early 70s had been recovering from a
massive heart attack and was about to be discharged.
As Chichwak stepped down to the cafeteria for a bite,
the woman was sitting in her room combing her hair,
nibbling from a food tray and waiting for her family
to come take her home.
So when a Code Blue call brought Chichwak rushing back
to her unit, she was shaken when she saw whom it was
for: the elderly woman waiting to leave. Despite frantic
efforts to revive her, the woman died on the spot-the
victim of a ruptured ventricle, which occurs on rare
occasions after a heart attack.
"She was feeling so good when I left," Chichwak
said. "It was such a shocking experience."
Several months later, it happened again.
This time, Chichwak and her colleagues were preparing
to discharge a middle-aged man after helping him for
weeks to recover from a stroke. Chichwak had just phoned
his family with the good news when she passed by his
room and saw him slumped in his chair. It was over quickly
after that, as the man died from a massive blood clot.
"It was the same eerie thing," Chichwak explained
in a voice that still sounded a bit incredulous. "He
was cheerful and more sociable than he had ever been,
and then suddenly he was gone."
For many of the nation's nurses, particularly those
who work in intensive care and other serious illness
units, death is an unfortunate part of the job. Few
nurses, however, will tell you that they ever get used
to seeing patients die-especially when it occurs unexpectedly.
As sad and difficult as the passing of the terminally
ill may be, it is the sudden death of a patient who
appears to be on the mend that many nurses find particularly
difficult to handle. Such incidents, they say, often
force them to deal with a number of complex issues that
usually do not accompany an expected passing-issues
that, if not properly addressed, can eventually take
their toll.
First and foremost are the range of emotions that arise
from such a traumatic event. In addition to feeling
intense shock and grief, many nurses tell of feeling
confused and helpless-and even guilt-ridden that the
death somehow was the result of something they had overlooked.
As many in the profession can attest, taking time to
digest all of these emotions during a rotation is a
luxury few nurses can afford.
"The pace of nurse work is relentless and so there
is little time to stop when we lose someone that way,"
said Alice Weydt, RN, director of patient care services
at Immanuel St. Joseph's Mayo Health System in Mankato,
Minn.
What's more, it is often the nurse's job to attend
to the body after death-and so many nurses must quickly
move from trying to save a patient to the grim task
of preparing the deceased for the family. "We have
to pull out all of their tubes and lines and clean them
up to make them look as nice as possible for their family,"
Chichwak said.
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