How do you react when your patient dies?

[engine296]

I try very hard to stay detatched. I give the patient everything I have and walk away when care is transferred. I rarely follow up on a patient's condition unless it is to determine the effectiveness of something I did.

This approach doesn't always work, but it helps.

Me too. I don't really want to know. At first I would ask, but the awnser was almost always bad. Now if I get 'em to the ER alive that's enough. I try to remember it's not the MVA or the cardiac arrest that killed 'em, it's the hard living and dumbass mistakes before that did it.

[tracker722]

***********************

[Safetyhit]

While I have seen my little share, I pray God never makes me hold a child as they gasp for breath while dying, especially just because I stop to help at an accident. Very much like you, I would undoubtedly be in for some extremely bad times.

[Deputy25]

I've been an LEO for 20 years and an RN (surgical/transplant ICU) for four. I've seen plenty of death, violent and otherwise. I'm sorry to say, it doesn't upset me as much as it once did. I'm still a part-time LEO, but witness a lot more suffering as a nurse. My wife is also a nurse at the same facility (trauma surgery), so we talk about it often. Seeing so much suffering, I guess if we let it bother us to the extent that it should, we would be incapable of functioning.

[Tmed]

Go to see you on here Truck. I respect what you've seen and done wanted a little of your input.

I think that anyone that can endure a career (long or short term) of this business needs to be applauded. No one should ever see then things we do, and for much of nothing in compensation.

I hear everyday, "I couldn't do what you do." My usual response is to brush it off because I honestly don't know what to say. Most of the time I say, "Someone's got to do it." It is nice to see that there are others out there that go through the same wave of emotions, or not at all, that I do, and that I'm not weird.

I hope one thing we all can take away from this thread is exactly what Citizen says, to be able to refocus our attitude through all the BS calls to know what we actually train for. Again we do find ourselves on the front lines, maybe not like our brothers in the service, but the front lines of gang warfare, horrific motor vehicles crashes, and bizarre medical emergencies. We are expected to function and make that critical decision; something that we have done before, and will be called upon again when time is of the essence.

I have to admit when I saw the title of the post I thought Hmm a bunch of youngsters who have to get a little seasoning. I skipped over it many times because I did not want to hear some Rookie giving advise about how they handled their one DIF. However after reading it, the thoughtful comments from old heads like me got me to thinking. When you first set off on this path (To be a Sheepdog and not a Sheep)you think you are invincible and nothing can touch you. Later of course you find no matter how hard you try, everything has it's effect on you. It is really how you take it that makes the difference. I think in the final analysis for me at least, as long as I know I did my best for the person or situation then that has to be enough. As truckie says maybe in the next post, we did not put them there (hopefully). No matter how much you train or even how much experience you have you can never really be ready for some calls. The best you can do is keep your head about you and try to keep the scene and everyone on it moving in the same direction; hopefully forward. This job does take so much from you. Truckies statement about patience and compassion are dead on the Mark. There is really not enough to give to everybody anymore, so it is saved for the deserving. Like Truckie this is all I have ever really done since my late teens. Maybe other professions lose compassion as well but it seems like this one (Sheepdog) is the worst. You have to be self aware to make sure it does not affect your relationships with other people. Even then... Thank god for the Station where you can go back and decompress before you go home. And for friends who will be brutally honest with each other. How do I deal with losing Patients? I train for the worst, do my best and then go home and leave it at work as much as possible. How do you deal with working on dying friends, team mates? Do your best, never ever give up( so you can sleep at night, and look their widow in the eye) and you find someone to talk too who will listen. No it's not a sign of weakness to talk to someone. Just make sure that who you are talking too knows where you are coming from. Most people in that profession don't have a clue what the warrior mentality really means and they may not help much. Anyway hope this helps even though it is quite late.

[Truckie]

Tmed,
Hello. Your words are surely born of experience and wisdom. From one old goat, my respect is yours. Thank you for your post, and thank you for your service. Get to Virginia, the suds and Rib Eye are on me.

In case there are youngins' here, some words of advice... words written long before me. But, words that ring clearer with every passing day:

Train and physically/mentally prepare for the worst.

When you respond, expect the worst... when you arrive, anything less than that is a relief, and you'll never be caught off guard. Scaling back is easy. Ramping up behind the curve, not so much.

Play hard, love hard and find a way/mechanism to put the job in a place where it cannot spoil your life.

Lean on your partners, and never betray the "Brotherhood."

[Tmed]

Wow Truckie I wish i were as eloquent as you. You said it all in nutshell. If you are ever in Alabama PM me and the Beer and Steaks are on ME!

[DrScooter]

I'm a 16 year RN, all but my first 2 years (Tele, ICU) have been ER. It's all I want to do, as ADD as I am chaos is what I do best. Each of us sees things different and how we handle trauma. No one, I think ever forgets the first human death we witness but for the most part I am able to leave it at the job. Because it is my job I try to not think of a save as anything special, it's my job. If I was a truck driver (and I was) and did the same save I'd be a hero but I'm a medical pro now, it's waht I do. When someone is dead despite what was done and I must note it's rare a code happens perfect but as long as we do our best for ourselves and the pt I move forward. Seemingly, it does not haunt me or my dreams, your milage my vary.

Yes, I hate pediatric codes, we almost never win and it's a child with a life ahead. I hate working house fires. In some of my trauma training, I rode a rig for a few days, worked a few MVA's and got in on more "Cabulance" calls than I could stand. Many people are not cut out for this, those of us who choose it and stay have our reasons. I could give up Nursing and the ER, one must examin one's career choice when we thank people for giving us urine. Two of my fellow ER nurses are EMS guys, one is still a Fireman and an ER Nurse part time, his wife didn't want him with too many woman so Fireman first. Actually, he is divorced now, the other did EMS and was into "chopper" transport but with 5 kids, well you know went for the cash.

Like I said I could leave ALL work long behind lie on a beach and never look back if I had the money, which I don't. If I have to work, which I do, for the most part this is fun, exciting and I really enjoy the "type" of people who choose this and I get the pleasure of meeting and working with. Besides, we have much better stories to tell than any bean counter.

[browningboy84]

I have to admit when I saw the title of the post I thought Hmm a bunch of youngsters who have to get a little seasoning. I skipped over it many times because I did not want to hear some Rookie giving advise about how they handled their one DIF. However after reading it, the thoughtful comments from old heads like me got me to thinking. When you first set off on this path (To be a Sheepdog and not a Sheep)you think you are invincible and nothing can touch you. Later of course you find no matter how hard you try, everything has it's effect on you. It is really how you take it that makes the difference. I think in the final analysis for me at least, as long as I know I did my best for the person or situation then that has to be enough. As truckie says maybe in the next post, we did not put them there (hopefully). No matter how much you train or even how much experience you have you can never really be ready for some calls. The best you can do is keep your head about you and try to keep the scene and everyone on it moving in the same direction; hopefully forward. This job does take so much from you. Truckies statement about patience and compassion are dead on the Mark. There is really not enough to give to everybody anymore, so it is saved for the deserving. Like Truckie this is all I have ever really done since my late teens. Maybe other professions lose compassion as well but it seems like this one (Sheepdog) is the worst. You have to be self aware to make sure it does not affect your relationships with other people. Even then... Thank god for the Station where you can go back and decompress before you go home. And for friends who will be brutally honest with each other. How do I deal with losing Patients? I train for the worst, do my best and then go home and leave it at work as much as possible. How do you deal with working on dying friends, team mates? Do your best, never ever give up( so you can sleep at night, and look their widow in the eye) and you find someone to talk too who will listen. No it's not a sign of weakness to talk to someone. Just make sure that who you are talking too knows where you are coming from. Most people in that profession don't have a clue what the warrior mentality really means and they may not help much. Anyway hope this helps even though it is quite late.

I am not a rookie, but I have been in EMS four years, and was a volunteer fireman for 2 years prior to that. I was in nursing school, got burned out on it, and switched to the pre-hospital side. I went through EMT school, then went straight to Paramedic school. It infuriated my parents, because I gave up on nursing school. My father is a physician, and told me I was wasting my time. I have spent the last 3 years working 160+ 24 hour shifts on an ambulance, and have run a few codes to say the least. I just went back to the agency where I started out as a rookie firefighter, and went back as a shift captain and a training officer.

I still think about some of the codes that I have worked, and some of the calls. I worked a pediatric drowning in EMT school, and the child's father was a preacher, who ironically enough, was off preaching a funeral when his child wandered outside and fell in the pond. We worked that kid for 2 hours, got him back, but he died 24 hours later. In the EMS room at the hospital, there was not a dry eye there. I almost quit EMT school after that day. I gutted it out, and I have never regretted it. That child gave me nightmares for the longest time. What helped me tremendously was delivering and rescussitating a child who delivered with the cord wrapped around its neck. The kid made it, and his mother saw me on duty 3 months later, and showed me the kid. I held that child in my arms and realized he is alive today cause I held it together, and did what I had to do for the 28 minutes it took to get to the closest hospital. I rarely ever have nightmares anymore, and I know of 3 people who I have brought back from the reaper.

I did landscaping in high school and part of college( I took over the business when my brother started medical school), but had a heatstroke at 19 years old. I had to get out of landscaping, but I found my calling in EMS. I am going back to nursing school, but I will not leave EMS until I have to( ie back problems, shoulder problems, knee problems). I have driven my great-uncle in as he way dying from CHF, got him to the ER alive, and watched him code in the ER. That was tough, but not that tough, since I knew he had lived to be 73 years old.

Someone asked me one day what EMS was like, what have I seen, etc. I told them this " I have seen life end in the back of the bus, and I have seen life begin. There is no rougher feeling watching someone die while you are doing all you can to prevent it, and there is no better feeling having part of a new life beginning".

I deal with things the best way I can (ie cutting up at the station with co-workers, hunting, fishing, and training retrievers), but I am lucky that I have a wife who is in this field. I am so lucky that I have a wife who hunts, fishes, and shoots with with me, and understands what I go through. I was so proud last month when she graduated from Paramedic School top in her class, and was even prouder when she passed her National Registry. I have obtained my instructor certs in some Life Support courses, and am supposed to help start teaching soon. All in all, it does take a special breed of person to do this, but I dont think I am anything special. It is in my blood, and my family has traced our lineage back to Cornwallis Wall, a surgeon in the Alabama Millitia in the Civil War. Medicine is in my blood, and I love that fact, since I know I found my calling in this field.

[Tmed]

Good for you. I'm glad you found your calling. Take good care of a mate who is understanding, and shares your hobbies. They are more important than anything.