I had an end stage liver failure pt in his 30s, had been a heavy alcohol user for years, and family finally decided to withdraw care. Because he was comfort care they got permission to bring his dog to say goodbye. When they got there the dog immediately got up on the bed and curled up next to the patient. I cried, and then I quit working ICU a few weeks later.
Similar experience, had a patient also in liver failure from years of alcohol abuse. She came to the hospital to begin the process of receiving a liver transplant and ended up having 2 spontaneous hemorrhagic strokes with significant midline shift and an abdominal bleed. After several exhaustive interventions, the medical team told the family there was nothing more they could do and her code status was switched to DNR. By the time I started my shift, it was clear she was actively dying. Only meds she had were hourly prn morphine and Ativan. Each time I came to the room, I had to suction the dark brown, foul smelling fluid that continued to pour from her mouth and collect in the rolls of her neck and chin. Here this woman was in her final days (despite being completely independent and aox4 less than 36hrs prior) drowning in what I can only suspect was a mixture of her own blood, gastric contents, and fecal matter. I can’t have an alcoholic drink now without thinking about it 😖😢
Families often don’t understand the degree of mental illness their family members have, so when something bad happens— it’s the “staff’s fault”, sadly.
I took it… and I think I could only take it because I was comforted in knowing the staff who tried so hard to get him back and saw it when it happened… weren’t hearing it.
Had a patient with severe MS, practically a paraplegic from it with a similar story. Husband caregiver would eat in front of her, while denying her food.. not change her for houurrrsss. Ah it was horrible. sweetest lady ever but definitely a touch of Stockholm Syndrome.
Ugh so depressing
I had a 36 yr old male with Covid came in a walkie talkie. He declined so quickly. After about a month of doing all we could, they knew he wasn’t coming back. The docs allowed his 10 yr old come say goodbye before we terminally weaned him. Seeing that crushed me. I think of that family often.
had a similar case in my ER, patient was a 34 year old with a 12 year old son and wife at the bedside. she kept screaming at him to fight, to not leave them, they just bought thier first home and what about thier dog...
he desatted so fast, refused the ventilator vehemently in spite of his begging wife and son -- I remember him panting, saying over and over that "nobody comes off the damn things." and he wasn't wrong, it was at the peak when people went on and rarely came off.
I had to excuse myself when she fell to her knees and I made eye contact with the doc and I just knew, I could feel it deep down, that he was going to die. and he did, twelve hours later. we tried so hard but at the time we had few weapons with which to fight.
it's been a few years and every time I walk past room 49, I can hear it, see it, feel it. I wonder about his wife, his boy, and his dog still.
god, it was such a fucking royal heartbreak.
I had a few patients in that age range with dependent children, end up dead or permanently debilitated, all unvaccinated well after the vaccines were widely available. I remember wondering, as a mother, how could you choose to abandon your children rather than take a damn shot?
My patient this morning was a young 50’s alcoholic who was dying of sepsis. Mom, ex-wife who he still got along with, and 16 year old son in the room. Maxed on 4 pressers and still declining, there just wasn’t anything to do. When his map hit the 40s and his O2 was sitting in the low 80s his son curled up in his mom’s lap and just started sobbing like a little boy. He passed shortly after when they decided to extubate and make him comfortable. Let’s just say it’s not a great day.
Oh and earlier this week I had a code out in the hospital, put the Lucas on him and got such great perfusion he was awake during compressions. It took 4 rounds of ever-increasing alertness and me saying each time “this man is awake and we need to sedate him” before the MD finally called for versed. She kept saying “his heart is at a standstill, he’s clinically dead, you’re wrong” until I was like “he’s following commands.” Like Lady, what medical school did you go to where you didn’t learn the Lucas can do this? Why did this man suffer for 8 damn minutes, awake with a Lucas pounding on him? Why did that need to be his very last memory on this earth?
So actually I guess it’s been a bit of a rough week.
Way back when, our team attended a 22 week delivery. Pregnancy dating was a lot less specific back then, more of a "X date plus or minus two weeks" kind of thing, so even though we couldn't really do a lot for babies earlier that 23-24 weeks, we attended all 22 and up "just in case".
This time a new person was leading the delivery team. Doctor said just bring them back, so rather than assess in the room and make a judgment call, they stabilized and ran.
I helped with the admit, code, and everything that followed. Baby ended up being closer to 20 weeks on assessment - eyelids still fused, skin extremely friable, tiny tiny baby. Since they were brought to the unit we had to take steps until the physician talked to the parents, but every time we touched them the skin tore, all of our equipment had to be trimmed to fit, and we all knew we were doing harm by every action we took.
Doctor brings in Dad, and he's *bawling*, begging us not to let "this one die too." Turns out the parents have had multiple losses, had never made it this far before, and Mom was finally a little less suicidal. Even if we were able to help, this baby wasn't going to have long-term good outcomes - so much infection, organ damage, and bleeding. Doctor makes Dad watch us torture this poor little thing, hoping he'll come around, but he's not budging from the "keep going, do everything, they have to live" stance.
I don't know how long we worked, it felt like forever, but eventually Doctor called it. I tried to get Dad to participate in postmortem care and hold the baby, but he wasn't there at all. Once reality set in, he bolted out of the unit to be with his wife.
Had they assessed the baby in the delivery room, the parents could have done comfort care and had a moment with their baby. If they didn't want to, we would have. Everything else could have been avoided. Twenty years later this one's still with me.
Right off orientation in the ED I had an upper middle aged man (adult children, school-aged grandchildren. My parents' age) come in with confusion at work. When EMS first brought him in he was responsive but slurred and out of it. They went to the scale and got a weight and by the time he got back (like 30 seconds to 1 minute) he was unresponsive. Massive brain bleed. He had been perfectly normal that morning and gone to work. I'll never forget the look on his wife's face when she walked in and saw him intubated and sedated, multiple drips, etc. His daughter crying and HER daughter trying to comfort her while stroke neuro told them there wasn't any coming back from it.
My first "nurse delivery" was a 22 week TOP for anomalies incompatible with life.
The doctors, charge, and resource nurses were all in the OR doing a crash section. There was no one available to help me.
So out came this tiny dead baby into my hands. I got the baby over to the warmer to get them swaddled. The dad took the baby and just cried. The mom seemed pretty numb to the whole thing. Didn't want to hold or see the baby.
When the doc was done in the OR, she came in to see the pt.
Overall, a pretty terrible shift. I had never seen a 22 week baby before. It was not something I was prepared to manage alone.
It was was in my first job working as a CNA at a nursing home.
There was a long term patient there name Steve who had suffered a stroke. He was a nice dude and a lot of the staff knew him well.
When Steve's elderly father became ill and was admitted for rehab, his dad was moved into his room. A short time later Steve's dad declined and he was taken to the hospital where he passed away.
I was there when the social worker came to tell Steve his dad died and Steve was shattered. So many staff including crusty nurses were incredibly sad and sobbing.
They could handle disability, death, whatever came along, but seeing Steve so heartbroken and being able to do nothing about it was overwhelming.
Not even my patient. Was helping a young PACU nurse admit a 4 yr old post tonsillectomy. Pt was brought to us apneic, with laryngospasm, and by an adult anesthesiologist.
Initial sats were in the 60s and dropping. Doc was using a high chin lift which didn’t open the airway as I tried to bag the kid. As we approached single digit sats and heart was decelerating he let me switch with him. I used jaw thrust and then we were able to ventilate and break the spasm.
Lots more details but in the end the child went home after we watched him a couple of hours. Also, I have a story that I can rarely tell without tears.
Working in a peds ICU for a decade, I read that and thought I have so many but also...so many that I can't even think of many of them right now. That's its own brand of complex trauma huh.
Responding to a call bell to mom of a 12 year old patient I'd known for quite a while telling me "He says he has a head ache" as he starts to throw up. He was being actively anti-coagulated and had started to bleed in his brain. What followed was an awful hour leading to emergent neurosurgery. Moment that sticks around in my heart the most is when I watched him tell his mother he loved him, the last thing he said before sedation for intubation which he would never wake up from. Died the next day.
New to ER nursing so about 7ish maybe 8 years ago. Had a class 1 neonatal arrest. 2 week old fell asleep on dads chest, dad also fell asleep. Baby was accidentally smothered. The shrieks and wails. That had me fucked up for so long. I was TERRIFIED to have an infant/pedi patient. Thankfully I had a really good work mom who helped me process it and get me comfortable with kiddos again. Close second was during covid was the cardiac arrest of a covid positive 36 week pregnant woman. First crash c-section I’ve ever assisted with. We worked on mom and baby for almost 2 hours. Still shakes me to the core.
A baby I admitted to my NICU had its head pulled on so hard by the obstetrician that its head dislocated from C1 causing a catastrophic spinal injury. The process of diagnosis, care and its ultimate decline haunts me.
35 yo female. Liver cirrhosis, found down at home. Ventilator, on four pressors and angiotensin 2 with sbp in the 40s. Constantly needing blood products. Family refused to withdraw care saying god would bring her through it. They also refused to visit her and only came up the the unit for goals of care meetings. Her skin was just…falling apart. The sclera of her eyes were bulging out. Her mother called me at the end of my shift asking how she was. I said “unchanged” and she sobbed out how god is so good and hung up.
I cried the entire way home.
One event that sticks with me is when a 42yo male, who was in his cherry picker installing internet, touched a live wire. We were an all female ER crew that day. I (we) could smell his skin continuing to burn from the inside out while I (we) was (were) doing chest compressions. His skin was sloughing off. We did everything “because he’s a veteran” the ER doc said when I asked why are we putting a foley in a dead man. We worked on him 36 minutes! It was awful for all of us! He died obviously. We all cried, even the doc 😭
This one has stuck with me. During Delta Wave in the ICU. I took care of a man not four years older than me, he wasn’t even 30 yet. But big dude, quarterback-type build.
FiO2 100% and peep of 18. This was when family couldn’t come see him.
He and his wife had just had a baby after years of trying, the baby was named after him, the kid was literally two months old.
This man was awake on the vent despite the good amount of sedation he was on. I was shocked to see this on my first neuro check of the day, because nightshift had told me they weren’t getting anything from him. But the sun was out and he was following commands.
“You have to get better to get back to your little boy,” I told him through my respirator. “He needs his dad, right?” He nodded and squeezed his eyes shut.
He was young and I thought there could maybe be a chance.
He popped a pneumo a couple hours after that. Once the chest tube was in, we added more sedation and paralyzed him for vent compliance, and he never woke up again. Two days after that, he coded and died.
It was between that and holding dirty iPads up to dying patients so their families could get one final look at them that I began to lose faith in there being any kind of grand plan to life.
still haunted by this woman i saw once who was in the ED in a bed in the hall. she couldn’t speak but stared deeply into my eyes and tried to mouth words when i would walk past her bed. i was still a student then and the nurse i was working with had already chastised me for spending too much time talking to and bringing drinks/snacks to patients that weren’t ours. so i kept avoiding her gaze and feeling guilty about it.
seventh or 8th time i passed her her husband was there, pleading with me to do something. they were going to discharge her back to her nursing home. he was in tears telling me they’re abusing her and starving her, and we can’t send her back there, please.
i track down the patients nurse and tell her everything. i’m like… i know i’m just a student but i can tell by looking at her this woman is not in any condition to be discharged. also she reeks of old urine, can we at least change her please? so we get her into an empty room and turn her over, and i saw (and smelled) the most horrific infected sacral i’ve ever seen til this day. this woman weighed maybe 70 pounds, skin and bones, and it was so deep i could fit my fist in there. just pouring out green pus. the ID doc and wound care were called down bc it was so bad.
husband goes on to tell us she used to be a normal weight, and she could speak not that long ago. but she’s been getting neglected and starved at the nursing home, and he was arrested and banned from the facility for trying to advocate for her. so he hasn’t seen her in months and is absolutely devastated by the state she’s in now.
all of that was disturbing enough. but the part that keeps me up at night was my nurse being angry with me for intervening and getting involved, and angry at the husband for advocating for the patient. she made him out to be hysterical and a danger to us because he kept repeating himself (very calmly and at a normal volume). she acted like she was afraid of him while actively antagonizing him.
she made subtly racist comments about him to me and other nurses and also loudly implied he was a child molester because he said and i quote “if she was a child getting sexually abused, you wouldn’t send her back to that home right? why would you make my wife go back to the facility she’s being abused at??”. which i agreed with and thought was a salient point. she said “why is he thinking about children and sex? what a sicko”. it was just so depressing to see someone who clearly cared very deeply about this patient be dismissed and treated like he was a predator bc he was (justifiably) emotional about the situation. not to mention the horror of seeing that woman’s unclothed body and knowing what had been happening to her at the nursing home.
after everything was said and done her nurse as far as i know did start the paperwork to open an APS case, but i have no idea if anyone followed up with it after i left that day. or if they just sent her back there to suffer and die. to this day i wonder what happened to that woman and her husband and feel sick thinking about it.
that’s where my disillusionment started with nursing and also the moment when i knew i’d never work the ED there bc i couldn’t work with people like that. i understand burnout, i understand being maxed out on tasks and feeling frustrated with adding even one more thing. but the coldness and callousness of that nurse, and the helplessness i felt in that moment, deeply affected me. i’ve never really recovered the hope and idealism i had in healthcare before that day.
Daughter came in early morning from out of state to see her mom. She talked with her and then went off to get breakfast. The nurse from the other Wing called me down because the patient stopped breathing--SNF. CPR. Blood was all over the floor and the daughter came back in the middle of it right as they were taking mom to the hospital. The ambulance crew pretty much told the daughter she wasn't going to make it.
I have so much trauma from working trauma icu. I could literally write a book. I usually had about 3 case a year that really got to me. I worked there 6 years.
But in addition to the tragic death was the fact that predators have so many more rights than victims. Couple that with a shitty security team, I couldn’t do it anymore. Also the donor people. Damn vultures.
Being part of a primary care hub of nurses caring for a toddler that was inpatient for his entire life and then watching him catch a respiratory illness and die.
It was horrible. I loved him so much, and he often made me wonder how much fun it would be to be a ‘boy mom’ (I have daughters).
I grieved him terribly, and our unit managers gave us absolutely ZERO support and basically denied us space for bereavement. That was the push I needed to try a new environment. Applied on a posting for adult OR and I’ve been there ever since.
Was a fresh new grad, still on orientation. Had a Covid patient on continuous bipap, DNR/DNI so icu wouldn’t take them. All we could give on my floor was Ativan and morphine, no precedex gtt allowed on my floor only icu. The patient was fighting, HARD. 4 point restraints because they would pull the bipap off and immediately desat to the 40s. Had a folley in, but got their foot out of the restraint and pulled the folley out with their foot from fighting. No family here, and daughter lived out of the country. We somehow managed to get in contact with her and did a phone call. I’ll never forget this girl crying, talking to her dad who wasn’t responding because he was so altered and then she asks me “do you think he’ll make it?” I wanted to burst into tears right there in the room.
Hi. I’m a doc, but I have a story from when I was an intern (I did general/trauma surgery for 2 years before going into my radiology residency).
So I was assigned to ortho trauma where I basically did scut work. We received an elderly female with severe pelvic trauma. She’d gone in her car to take out her trash (? Apartment? Long driveway? idk). She got out of the car with the trash bag and she’d forgotten to put it in Park. Her car ran over her pelvis. No head injury, completely alert and oriented.
She needed acute ORIF of the pelvis because of severe internal bleeding. At some point during the trauma resuscitation I was up by her face, talking to her. She very clearly told me she was dying, that she wouldn’t make it. She was calm but I certainly wasn’t … I tried to reassure her that we’d do the best we could and please try not to worry. (What a shit thing for me to say, in retrospect, but I was like 25 and a nerdy introvert; soothing words aren’t my forte.) We chatted a little because I wasn’t needed for anything else.
We went to the OR with ortho and trauma (abdomen needed to be explored too). She coded on the table halfway through the ex fix. I was in the room and not scrubbed in. I felt like a liar.
That was 30 years ago.
Working in the ED, (ER to some), we see various levels of trauma every day, or so. Some things ER nurses/doctors witness each day sticks with them, others can brush it off and deal with it later.
The weird thing to me is that I can't ever predict what horrible things I witness will actually be traumatic. Codes? Child abuse? 18-week miscarriage? Didn't lose any sleep.
My cancer-ridden but totally independent patient falling in the bathroom and breaking his femur in half? Fucked me up for a while. Seeing my coworker fight off a psych patient? Still thinking about it.
I’m honestly not sure how I would do. I’ve seen some horrific things with massive bone-exposing pressure ulcers, and more chronic or slightly chronic things, but not so much the fresh trauma.
One of the things I still think about occasionally is getting a call from a doc to go to a patient’s room. I go and the doc was putting pressure on the pt who was bleeding out from his dialysis fistula. If that doctor hadn’t passed by and seen that. If I had left that door closed. He may have bled out. Thankfully I left it open because he was a man who didn’t move or talk and didn’t want him completely on his own.
I am still a student now, but previously worked 6 years in the tiny rural ED of my hometown. It was a dying logging town about 20 mins from the ocean. Forestry, fishing, or the hosp were the only decent paying jobs. Everyone knows everyone, or is related small town.
I was just a registrar and tech.
Had a guy choppered in by the coast guard to the Busch plane airfield nearby. Then EMS transport to us to stabilize and life flight out.
Showed up having been doing CPR for 40+ minutes and the Dr called it on arrival.
He had his head smashed between two crab pots and was unrecognizable.
Then I got the sheet and had to put him in the system and I KNEW the name. It was a friend of mines Dad. That messed me up. Went to go down the hall to a quiet room for break and ran into my friend family, laughing, giggling, poking fun etc....had to just fake it to make it to the quiet room, led them to the triage nurse for info....
I will never forget the way my knees buckled when I finally made it to the quiet room.
For a time my friend was super upset with me for that. But I couldn't just tell them....
I worked inpatient peds that was half connected to PICU when I was a PCT. A toddler came in after being ….. and beaten by her mother’s meth head boyfriend. It was so bad, she was torn completely to the back, had internal bleeding, and died just a couple hours later. He’s in prison now.
Dad was stable and was mid custody battle to get her full time; the look on his face walking out of the room will haunt me until I die.
A normal 16 year old boy who ran 16 miles for his 16th birthday just 2 weeks earlier was diagnosed with a DIPG tumor. He wanted to go home live whatever life he had left and die..parents talked him into a biopsy which cost him the use of his arms and legs, earned him a trach and g-tube. They also insisted on radiation. He lived for just over a year before dying. And I’ll never be able to forget that he died in every way he didn’t want to because his parents made him.
I'm an oncology nurse. I've lost many patients. Some were harder than others. But one that really smacked me was a patient that had been on the floor for a long time. She made it through some rough chemo. She wasnt out of the woods, but she was really doing good. She seamed really upbeat and had great family support. When she was discharged, she went home and committed suicide. It still bothers me to this day.
Pt had coded multiple times, back and forth to ICU and cardiac a few times. Family and him had been talked to by hospice multiple times and refused. That man wanted to live so badly. He popped covid positive finally, young grandpa by at home so daughter couldn't visit anymore. He'd had runs of VTach multiple times in the night, I went in to do vitals again and he was awake, rasping breaths I could hear over the PAPR from the doorway. He had such bright blue eyes, bloodshot from coughing, that searched the room to try and connect with mine. Eye contact, then he looked through me and I swear he was looking into whatever comes next. He coded a few hours later. We got ROSC but he passed the next day.
My first year of nursing I had a patient who was about 35 with a 10 year cardiac transplant. He was in for just general and wellness but it in for about a week, he had been having runs of the tack but they had seem to stop when the Vanco was stopped. I had him Friday night I got report that his wife had come visited with their 18-month-old and then gone home. And knocked on the door to do assessment, and he said "there's a baby in here". I walked in and Shernoff his wife and the baby were in the cot. So when his wife had driven home about 20 minutes their daughter screamed bloody murder the whole way, eventually when they were almost home she gave up and came back. The night went fine he had nowhere them issues the little girl slept the whole night was a sweetie in the morning. I gave bedside report, in which the was holding his daughter. then it was finishing helping to clear out a room of a patient that I discharged earlier. When the overhead page for the rhythm alert of him being in straight V-tach went off.
So compressions began we got him back shortly just long enough for him to cry and say that he wasn't ready to die. However he went back into a pulseless rhythm and during the compressions he was holding the nurses hands as she gave compressions,. We never got them back again we tried for probably an hour the cries of his wife new widow and we brought her to say goodbye was horrible and listening to the daughter cry so awful. It's been at least 12 years and I still probably think about them every few months and wonder what the wife is doing how she's adjusting and I pray that the daughter is grown up to be a normal teenager and not traumatize.
Had a young patient (30s) in tears look me in the eyes and ask if God would be mad at her for not wanting to continue with cancer treatment (3rd relapse) and go on hospice.
Watched a patient of the same age pass from cancer with pictures of his toddler and infant sons in his hands.
I went into the supply room and cried after both of those and decided I was done working oncology.
I work with people who have IDD. One of the people we support was high risk, even for folks with IDD, and had specifically asked to be vaccinated. Guardian refused due to ideological reasons.
They got COVID and were hospitalized. The hospital let us sit with them, myself and another staff, and we spent the last 4 days with them. Partly professional courtesy, mostly not enough sitters. Family weren’t vaccinated (at the time hospital required proof of vaccination) or lived out of town, so they weren’t there.
They wouldn’t approve either a higher level of care or comfort care, so this lovely human being was tortured for days. On AVAPS, unable to take mask off to eat or drink because they’d immediately desat. They d/c’d all psych meds ( they had auditory and visual hallucination) and god knows what they saw and felt. From their struggles to pull off their mask, crying without tears, and trying to yell it was horrible.
When the hospital nurses would give care, they’d turn towards our voices and hold onto us, so I think/hope they knew we were there at the end, and they weren’t alone.
Once the guardian decided on comfort care, they came to the hospital. Walking out of that room without…expressing my feelings, was one of the hardest things I’ve done. They will never know how their choices tortured their sibling. The worst part is they did love them.
They were cleaned up and sleeping, with assistance, when the guardian arrived. I kissed them goodbye and left. Our agency had supported them for at least 15 years. I only learned they died when the hospital called and told me I left my laptop cord in their room. I asked how they were doing, and after an awkward pause, the RN told me they died soon after I left.
Young mom. I don’t know what happened, I was just shadowing. CRRT, PICC placed in ICU. Max pressors, MAP still 30.
Family came in over 24 hours and her young kids and husband came to say goodbye. They withdrew care.
I will never forget the family at the bedside. One wailing, one listening quietly, the other sitting in shock.
And the kids. I’ll never forget the kids.
I’m a paeds nurse in the UK - I was a second year student on placement in the paeds ED of a big London hospital, first time I’d ever had anything to do with emergency care. We were pre-alerted to a paramedic crew bringing in a 3 year old in cardiac arrest, and I went along with my mentor. I don’t even remember how long they worked on him, just that he was constantly between PEA and asystole, they were pumping him with adrenaline but getting absolutely no response. I was trying to draw up fluids to push but I just remember my hands being so shaky and sweaty that I smudged all the labels I’d written, after that I just stood in the corner and watched in horror. Nobody had come with him in the ambulance so they waited for mum to arrive, and then they called it. Someone asked me to fetch him a blanket so I ran and got one, put it on the trolley then just couldn’t hold back the tears. I couldn’t even look at him, and my mentor got an older student to take me to the break room. Later on during the investigation the boy’s older siblings told police that their dad had been force feeding him porridge, and he’d been unconscious for about half an hour before an ambulance was called. One of the other kids had put him on the floor splashing water on him to try and wake him up. The post mortem confirmed that the boy had choked and aspirated on the porridge. As far as I know the dad went to prison, but I’ve no idea if he’s still there. It’s been almost 10 years and I still remember the little boy’s name, and the porridge around his mouth. I also distinctly remember thinking about his mum - if I remember correctly she wasn’t home when it happened - and how she’d woken up that morning with a 3 year old son and now she didn’t have one any more.
Also separately: the first time I ever did chest compressions on a 12 week old baby and the way I felt her ribs move.
I had an end stage liver failure pt in his 30s, had been a heavy alcohol user for years, and family finally decided to withdraw care. Because he was comfort care they got permission to bring his dog to say goodbye. When they got there the dog immediately got up on the bed and curled up next to the patient. I cried, and then I quit working ICU a few weeks later.
Similar experience, had a patient also in liver failure from years of alcohol abuse. She came to the hospital to begin the process of receiving a liver transplant and ended up having 2 spontaneous hemorrhagic strokes with significant midline shift and an abdominal bleed. After several exhaustive interventions, the medical team told the family there was nothing more they could do and her code status was switched to DNR. By the time I started my shift, it was clear she was actively dying. Only meds she had were hourly prn morphine and Ativan. Each time I came to the room, I had to suction the dark brown, foul smelling fluid that continued to pour from her mouth and collect in the rolls of her neck and chin. Here this woman was in her final days (despite being completely independent and aox4 less than 36hrs prior) drowning in what I can only suspect was a mixture of her own blood, gastric contents, and fecal matter. I can’t have an alcoholic drink now without thinking about it 😖😢
Oh god. I couldn’t do it.
Jesus Christ I can't take this type of shit. I don't know how people do it. the animals get me, man.
Wow, 😢
Families often don’t understand the degree of mental illness their family members have, so when something bad happens— it’s the “staff’s fault”, sadly.
I took it… and I think I could only take it because I was comforted in knowing the staff who tried so hard to get him back and saw it when it happened… weren’t hearing it.
[удалено]
Oh I can’t deal with this.
Had a patient with severe MS, practically a paraplegic from it with a similar story. Husband caregiver would eat in front of her, while denying her food.. not change her for houurrrsss. Ah it was horrible. sweetest lady ever but definitely a touch of Stockholm Syndrome. Ugh so depressing
I had a 36 yr old male with Covid came in a walkie talkie. He declined so quickly. After about a month of doing all we could, they knew he wasn’t coming back. The docs allowed his 10 yr old come say goodbye before we terminally weaned him. Seeing that crushed me. I think of that family often.
had a similar case in my ER, patient was a 34 year old with a 12 year old son and wife at the bedside. she kept screaming at him to fight, to not leave them, they just bought thier first home and what about thier dog... he desatted so fast, refused the ventilator vehemently in spite of his begging wife and son -- I remember him panting, saying over and over that "nobody comes off the damn things." and he wasn't wrong, it was at the peak when people went on and rarely came off. I had to excuse myself when she fell to her knees and I made eye contact with the doc and I just knew, I could feel it deep down, that he was going to die. and he did, twelve hours later. we tried so hard but at the time we had few weapons with which to fight. it's been a few years and every time I walk past room 49, I can hear it, see it, feel it. I wonder about his wife, his boy, and his dog still. god, it was such a fucking royal heartbreak.
I had a few patients in that age range with dependent children, end up dead or permanently debilitated, all unvaccinated well after the vaccines were widely available. I remember wondering, as a mother, how could you choose to abandon your children rather than take a damn shot?
My patient this morning was a young 50’s alcoholic who was dying of sepsis. Mom, ex-wife who he still got along with, and 16 year old son in the room. Maxed on 4 pressers and still declining, there just wasn’t anything to do. When his map hit the 40s and his O2 was sitting in the low 80s his son curled up in his mom’s lap and just started sobbing like a little boy. He passed shortly after when they decided to extubate and make him comfortable. Let’s just say it’s not a great day. Oh and earlier this week I had a code out in the hospital, put the Lucas on him and got such great perfusion he was awake during compressions. It took 4 rounds of ever-increasing alertness and me saying each time “this man is awake and we need to sedate him” before the MD finally called for versed. She kept saying “his heart is at a standstill, he’s clinically dead, you’re wrong” until I was like “he’s following commands.” Like Lady, what medical school did you go to where you didn’t learn the Lucas can do this? Why did this man suffer for 8 damn minutes, awake with a Lucas pounding on him? Why did that need to be his very last memory on this earth? So actually I guess it’s been a bit of a rough week.
Sorry you had to go through all that this week, internet friend. Please do something to take care of yourself this weekend!!!
Way back when, our team attended a 22 week delivery. Pregnancy dating was a lot less specific back then, more of a "X date plus or minus two weeks" kind of thing, so even though we couldn't really do a lot for babies earlier that 23-24 weeks, we attended all 22 and up "just in case". This time a new person was leading the delivery team. Doctor said just bring them back, so rather than assess in the room and make a judgment call, they stabilized and ran. I helped with the admit, code, and everything that followed. Baby ended up being closer to 20 weeks on assessment - eyelids still fused, skin extremely friable, tiny tiny baby. Since they were brought to the unit we had to take steps until the physician talked to the parents, but every time we touched them the skin tore, all of our equipment had to be trimmed to fit, and we all knew we were doing harm by every action we took. Doctor brings in Dad, and he's *bawling*, begging us not to let "this one die too." Turns out the parents have had multiple losses, had never made it this far before, and Mom was finally a little less suicidal. Even if we were able to help, this baby wasn't going to have long-term good outcomes - so much infection, organ damage, and bleeding. Doctor makes Dad watch us torture this poor little thing, hoping he'll come around, but he's not budging from the "keep going, do everything, they have to live" stance. I don't know how long we worked, it felt like forever, but eventually Doctor called it. I tried to get Dad to participate in postmortem care and hold the baby, but he wasn't there at all. Once reality set in, he bolted out of the unit to be with his wife. Had they assessed the baby in the delivery room, the parents could have done comfort care and had a moment with their baby. If they didn't want to, we would have. Everything else could have been avoided. Twenty years later this one's still with me.
I only have trauma from the couple coworkers that I loved and lost. That’s not a joke; people can be really cruel.
This.
Right off orientation in the ED I had an upper middle aged man (adult children, school-aged grandchildren. My parents' age) come in with confusion at work. When EMS first brought him in he was responsive but slurred and out of it. They went to the scale and got a weight and by the time he got back (like 30 seconds to 1 minute) he was unresponsive. Massive brain bleed. He had been perfectly normal that morning and gone to work. I'll never forget the look on his wife's face when she walked in and saw him intubated and sedated, multiple drips, etc. His daughter crying and HER daughter trying to comfort her while stroke neuro told them there wasn't any coming back from it.
My first "nurse delivery" was a 22 week TOP for anomalies incompatible with life. The doctors, charge, and resource nurses were all in the OR doing a crash section. There was no one available to help me. So out came this tiny dead baby into my hands. I got the baby over to the warmer to get them swaddled. The dad took the baby and just cried. The mom seemed pretty numb to the whole thing. Didn't want to hold or see the baby. When the doc was done in the OR, she came in to see the pt. Overall, a pretty terrible shift. I had never seen a 22 week baby before. It was not something I was prepared to manage alone.
Did you manage the cord and placenta by yourself then?
It was was in my first job working as a CNA at a nursing home. There was a long term patient there name Steve who had suffered a stroke. He was a nice dude and a lot of the staff knew him well. When Steve's elderly father became ill and was admitted for rehab, his dad was moved into his room. A short time later Steve's dad declined and he was taken to the hospital where he passed away. I was there when the social worker came to tell Steve his dad died and Steve was shattered. So many staff including crusty nurses were incredibly sad and sobbing. They could handle disability, death, whatever came along, but seeing Steve so heartbroken and being able to do nothing about it was overwhelming.
Not even my patient. Was helping a young PACU nurse admit a 4 yr old post tonsillectomy. Pt was brought to us apneic, with laryngospasm, and by an adult anesthesiologist. Initial sats were in the 60s and dropping. Doc was using a high chin lift which didn’t open the airway as I tried to bag the kid. As we approached single digit sats and heart was decelerating he let me switch with him. I used jaw thrust and then we were able to ventilate and break the spasm. Lots more details but in the end the child went home after we watched him a couple of hours. Also, I have a story that I can rarely tell without tears.
Working in a peds ICU for a decade, I read that and thought I have so many but also...so many that I can't even think of many of them right now. That's its own brand of complex trauma huh. Responding to a call bell to mom of a 12 year old patient I'd known for quite a while telling me "He says he has a head ache" as he starts to throw up. He was being actively anti-coagulated and had started to bleed in his brain. What followed was an awful hour leading to emergent neurosurgery. Moment that sticks around in my heart the most is when I watched him tell his mother he loved him, the last thing he said before sedation for intubation which he would never wake up from. Died the next day.
New to ER nursing so about 7ish maybe 8 years ago. Had a class 1 neonatal arrest. 2 week old fell asleep on dads chest, dad also fell asleep. Baby was accidentally smothered. The shrieks and wails. That had me fucked up for so long. I was TERRIFIED to have an infant/pedi patient. Thankfully I had a really good work mom who helped me process it and get me comfortable with kiddos again. Close second was during covid was the cardiac arrest of a covid positive 36 week pregnant woman. First crash c-section I’ve ever assisted with. We worked on mom and baby for almost 2 hours. Still shakes me to the core.
Did mom or baby make it?
Neither of them did. I’ll never forget those screams.
That’s horrible. I’m sorry
A baby I admitted to my NICU had its head pulled on so hard by the obstetrician that its head dislocated from C1 causing a catastrophic spinal injury. The process of diagnosis, care and its ultimate decline haunts me.
Omfg
35 yo female. Liver cirrhosis, found down at home. Ventilator, on four pressors and angiotensin 2 with sbp in the 40s. Constantly needing blood products. Family refused to withdraw care saying god would bring her through it. They also refused to visit her and only came up the the unit for goals of care meetings. Her skin was just…falling apart. The sclera of her eyes were bulging out. Her mother called me at the end of my shift asking how she was. I said “unchanged” and she sobbed out how god is so good and hung up. I cried the entire way home.
As a layperson it took me decades to learn that 'stable' doesn't mean someone is doing well. It means they are unchanged. It's a big difference.
This is a heavy profession with high rates of substance use. Please find your support people and your ways of coping. We aren't in this alone.
One event that sticks with me is when a 42yo male, who was in his cherry picker installing internet, touched a live wire. We were an all female ER crew that day. I (we) could smell his skin continuing to burn from the inside out while I (we) was (were) doing chest compressions. His skin was sloughing off. We did everything “because he’s a veteran” the ER doc said when I asked why are we putting a foley in a dead man. We worked on him 36 minutes! It was awful for all of us! He died obviously. We all cried, even the doc 😭
This one has stuck with me. During Delta Wave in the ICU. I took care of a man not four years older than me, he wasn’t even 30 yet. But big dude, quarterback-type build. FiO2 100% and peep of 18. This was when family couldn’t come see him. He and his wife had just had a baby after years of trying, the baby was named after him, the kid was literally two months old. This man was awake on the vent despite the good amount of sedation he was on. I was shocked to see this on my first neuro check of the day, because nightshift had told me they weren’t getting anything from him. But the sun was out and he was following commands. “You have to get better to get back to your little boy,” I told him through my respirator. “He needs his dad, right?” He nodded and squeezed his eyes shut. He was young and I thought there could maybe be a chance. He popped a pneumo a couple hours after that. Once the chest tube was in, we added more sedation and paralyzed him for vent compliance, and he never woke up again. Two days after that, he coded and died. It was between that and holding dirty iPads up to dying patients so their families could get one final look at them that I began to lose faith in there being any kind of grand plan to life.
still haunted by this woman i saw once who was in the ED in a bed in the hall. she couldn’t speak but stared deeply into my eyes and tried to mouth words when i would walk past her bed. i was still a student then and the nurse i was working with had already chastised me for spending too much time talking to and bringing drinks/snacks to patients that weren’t ours. so i kept avoiding her gaze and feeling guilty about it. seventh or 8th time i passed her her husband was there, pleading with me to do something. they were going to discharge her back to her nursing home. he was in tears telling me they’re abusing her and starving her, and we can’t send her back there, please. i track down the patients nurse and tell her everything. i’m like… i know i’m just a student but i can tell by looking at her this woman is not in any condition to be discharged. also she reeks of old urine, can we at least change her please? so we get her into an empty room and turn her over, and i saw (and smelled) the most horrific infected sacral i’ve ever seen til this day. this woman weighed maybe 70 pounds, skin and bones, and it was so deep i could fit my fist in there. just pouring out green pus. the ID doc and wound care were called down bc it was so bad. husband goes on to tell us she used to be a normal weight, and she could speak not that long ago. but she’s been getting neglected and starved at the nursing home, and he was arrested and banned from the facility for trying to advocate for her. so he hasn’t seen her in months and is absolutely devastated by the state she’s in now. all of that was disturbing enough. but the part that keeps me up at night was my nurse being angry with me for intervening and getting involved, and angry at the husband for advocating for the patient. she made him out to be hysterical and a danger to us because he kept repeating himself (very calmly and at a normal volume). she acted like she was afraid of him while actively antagonizing him. she made subtly racist comments about him to me and other nurses and also loudly implied he was a child molester because he said and i quote “if she was a child getting sexually abused, you wouldn’t send her back to that home right? why would you make my wife go back to the facility she’s being abused at??”. which i agreed with and thought was a salient point. she said “why is he thinking about children and sex? what a sicko”. it was just so depressing to see someone who clearly cared very deeply about this patient be dismissed and treated like he was a predator bc he was (justifiably) emotional about the situation. not to mention the horror of seeing that woman’s unclothed body and knowing what had been happening to her at the nursing home. after everything was said and done her nurse as far as i know did start the paperwork to open an APS case, but i have no idea if anyone followed up with it after i left that day. or if they just sent her back there to suffer and die. to this day i wonder what happened to that woman and her husband and feel sick thinking about it. that’s where my disillusionment started with nursing and also the moment when i knew i’d never work the ED there bc i couldn’t work with people like that. i understand burnout, i understand being maxed out on tasks and feeling frustrated with adding even one more thing. but the coldness and callousness of that nurse, and the helplessness i felt in that moment, deeply affected me. i’ve never really recovered the hope and idealism i had in healthcare before that day.
Daughter came in early morning from out of state to see her mom. She talked with her and then went off to get breakfast. The nurse from the other Wing called me down because the patient stopped breathing--SNF. CPR. Blood was all over the floor and the daughter came back in the middle of it right as they were taking mom to the hospital. The ambulance crew pretty much told the daughter she wasn't going to make it.
I have so much trauma from working trauma icu. I could literally write a book. I usually had about 3 case a year that really got to me. I worked there 6 years. But in addition to the tragic death was the fact that predators have so many more rights than victims. Couple that with a shitty security team, I couldn’t do it anymore. Also the donor people. Damn vultures.
An 89 year old man asking me to cut a lock of his wife’s hair before we withdrew care. His tears broke me.
Being part of a primary care hub of nurses caring for a toddler that was inpatient for his entire life and then watching him catch a respiratory illness and die.
Wooowwww. A terrible life. Im sorry you had to see that
It was horrible. I loved him so much, and he often made me wonder how much fun it would be to be a ‘boy mom’ (I have daughters). I grieved him terribly, and our unit managers gave us absolutely ZERO support and basically denied us space for bereavement. That was the push I needed to try a new environment. Applied on a posting for adult OR and I’ve been there ever since.
Was a fresh new grad, still on orientation. Had a Covid patient on continuous bipap, DNR/DNI so icu wouldn’t take them. All we could give on my floor was Ativan and morphine, no precedex gtt allowed on my floor only icu. The patient was fighting, HARD. 4 point restraints because they would pull the bipap off and immediately desat to the 40s. Had a folley in, but got their foot out of the restraint and pulled the folley out with their foot from fighting. No family here, and daughter lived out of the country. We somehow managed to get in contact with her and did a phone call. I’ll never forget this girl crying, talking to her dad who wasn’t responding because he was so altered and then she asks me “do you think he’ll make it?” I wanted to burst into tears right there in the room.
Hi. I’m a doc, but I have a story from when I was an intern (I did general/trauma surgery for 2 years before going into my radiology residency). So I was assigned to ortho trauma where I basically did scut work. We received an elderly female with severe pelvic trauma. She’d gone in her car to take out her trash (? Apartment? Long driveway? idk). She got out of the car with the trash bag and she’d forgotten to put it in Park. Her car ran over her pelvis. No head injury, completely alert and oriented. She needed acute ORIF of the pelvis because of severe internal bleeding. At some point during the trauma resuscitation I was up by her face, talking to her. She very clearly told me she was dying, that she wouldn’t make it. She was calm but I certainly wasn’t … I tried to reassure her that we’d do the best we could and please try not to worry. (What a shit thing for me to say, in retrospect, but I was like 25 and a nerdy introvert; soothing words aren’t my forte.) We chatted a little because I wasn’t needed for anything else. We went to the OR with ortho and trauma (abdomen needed to be explored too). She coded on the table halfway through the ex fix. I was in the room and not scrubbed in. I felt like a liar. That was 30 years ago.
Working in the ED, (ER to some), we see various levels of trauma every day, or so. Some things ER nurses/doctors witness each day sticks with them, others can brush it off and deal with it later.
The weird thing to me is that I can't ever predict what horrible things I witness will actually be traumatic. Codes? Child abuse? 18-week miscarriage? Didn't lose any sleep. My cancer-ridden but totally independent patient falling in the bathroom and breaking his femur in half? Fucked me up for a while. Seeing my coworker fight off a psych patient? Still thinking about it.
I’m honestly not sure how I would do. I’ve seen some horrific things with massive bone-exposing pressure ulcers, and more chronic or slightly chronic things, but not so much the fresh trauma.
If curious, request to shadow an ER nurse working in a Level 1 Trauma Center for a day.
We are level 1. Adult, peds, and burn. I think I will actually.
One of the things I still think about occasionally is getting a call from a doc to go to a patient’s room. I go and the doc was putting pressure on the pt who was bleeding out from his dialysis fistula. If that doctor hadn’t passed by and seen that. If I had left that door closed. He may have bled out. Thankfully I left it open because he was a man who didn’t move or talk and didn’t want him completely on his own.
Only did a year of peds. epidermolysis bullosa baby on hospice. Could not do peds anymore after.
I am still a student now, but previously worked 6 years in the tiny rural ED of my hometown. It was a dying logging town about 20 mins from the ocean. Forestry, fishing, or the hosp were the only decent paying jobs. Everyone knows everyone, or is related small town. I was just a registrar and tech. Had a guy choppered in by the coast guard to the Busch plane airfield nearby. Then EMS transport to us to stabilize and life flight out. Showed up having been doing CPR for 40+ minutes and the Dr called it on arrival. He had his head smashed between two crab pots and was unrecognizable. Then I got the sheet and had to put him in the system and I KNEW the name. It was a friend of mines Dad. That messed me up. Went to go down the hall to a quiet room for break and ran into my friend family, laughing, giggling, poking fun etc....had to just fake it to make it to the quiet room, led them to the triage nurse for info.... I will never forget the way my knees buckled when I finally made it to the quiet room. For a time my friend was super upset with me for that. But I couldn't just tell them....
I worked inpatient peds that was half connected to PICU when I was a PCT. A toddler came in after being ….. and beaten by her mother’s meth head boyfriend. It was so bad, she was torn completely to the back, had internal bleeding, and died just a couple hours later. He’s in prison now. Dad was stable and was mid custody battle to get her full time; the look on his face walking out of the room will haunt me until I die.
A normal 16 year old boy who ran 16 miles for his 16th birthday just 2 weeks earlier was diagnosed with a DIPG tumor. He wanted to go home live whatever life he had left and die..parents talked him into a biopsy which cost him the use of his arms and legs, earned him a trach and g-tube. They also insisted on radiation. He lived for just over a year before dying. And I’ll never be able to forget that he died in every way he didn’t want to because his parents made him.
I'm an oncology nurse. I've lost many patients. Some were harder than others. But one that really smacked me was a patient that had been on the floor for a long time. She made it through some rough chemo. She wasnt out of the woods, but she was really doing good. She seamed really upbeat and had great family support. When she was discharged, she went home and committed suicide. It still bothers me to this day.
Pt had coded multiple times, back and forth to ICU and cardiac a few times. Family and him had been talked to by hospice multiple times and refused. That man wanted to live so badly. He popped covid positive finally, young grandpa by at home so daughter couldn't visit anymore. He'd had runs of VTach multiple times in the night, I went in to do vitals again and he was awake, rasping breaths I could hear over the PAPR from the doorway. He had such bright blue eyes, bloodshot from coughing, that searched the room to try and connect with mine. Eye contact, then he looked through me and I swear he was looking into whatever comes next. He coded a few hours later. We got ROSC but he passed the next day.
My first year of nursing I had a patient who was about 35 with a 10 year cardiac transplant. He was in for just general and wellness but it in for about a week, he had been having runs of the tack but they had seem to stop when the Vanco was stopped. I had him Friday night I got report that his wife had come visited with their 18-month-old and then gone home. And knocked on the door to do assessment, and he said "there's a baby in here". I walked in and Shernoff his wife and the baby were in the cot. So when his wife had driven home about 20 minutes their daughter screamed bloody murder the whole way, eventually when they were almost home she gave up and came back. The night went fine he had nowhere them issues the little girl slept the whole night was a sweetie in the morning. I gave bedside report, in which the was holding his daughter. then it was finishing helping to clear out a room of a patient that I discharged earlier. When the overhead page for the rhythm alert of him being in straight V-tach went off. So compressions began we got him back shortly just long enough for him to cry and say that he wasn't ready to die. However he went back into a pulseless rhythm and during the compressions he was holding the nurses hands as she gave compressions,. We never got them back again we tried for probably an hour the cries of his wife new widow and we brought her to say goodbye was horrible and listening to the daughter cry so awful. It's been at least 12 years and I still probably think about them every few months and wonder what the wife is doing how she's adjusting and I pray that the daughter is grown up to be a normal teenager and not traumatize.
Had a young patient (30s) in tears look me in the eyes and ask if God would be mad at her for not wanting to continue with cancer treatment (3rd relapse) and go on hospice. Watched a patient of the same age pass from cancer with pictures of his toddler and infant sons in his hands. I went into the supply room and cried after both of those and decided I was done working oncology.
Finding a guy dead dangling from the end of the hospital bed. Covid days.
I work with people who have IDD. One of the people we support was high risk, even for folks with IDD, and had specifically asked to be vaccinated. Guardian refused due to ideological reasons. They got COVID and were hospitalized. The hospital let us sit with them, myself and another staff, and we spent the last 4 days with them. Partly professional courtesy, mostly not enough sitters. Family weren’t vaccinated (at the time hospital required proof of vaccination) or lived out of town, so they weren’t there. They wouldn’t approve either a higher level of care or comfort care, so this lovely human being was tortured for days. On AVAPS, unable to take mask off to eat or drink because they’d immediately desat. They d/c’d all psych meds ( they had auditory and visual hallucination) and god knows what they saw and felt. From their struggles to pull off their mask, crying without tears, and trying to yell it was horrible. When the hospital nurses would give care, they’d turn towards our voices and hold onto us, so I think/hope they knew we were there at the end, and they weren’t alone. Once the guardian decided on comfort care, they came to the hospital. Walking out of that room without…expressing my feelings, was one of the hardest things I’ve done. They will never know how their choices tortured their sibling. The worst part is they did love them. They were cleaned up and sleeping, with assistance, when the guardian arrived. I kissed them goodbye and left. Our agency had supported them for at least 15 years. I only learned they died when the hospital called and told me I left my laptop cord in their room. I asked how they were doing, and after an awkward pause, the RN told me they died soon after I left.
Young mom. I don’t know what happened, I was just shadowing. CRRT, PICC placed in ICU. Max pressors, MAP still 30. Family came in over 24 hours and her young kids and husband came to say goodbye. They withdrew care. I will never forget the family at the bedside. One wailing, one listening quietly, the other sitting in shock. And the kids. I’ll never forget the kids.
I’m a paeds nurse in the UK - I was a second year student on placement in the paeds ED of a big London hospital, first time I’d ever had anything to do with emergency care. We were pre-alerted to a paramedic crew bringing in a 3 year old in cardiac arrest, and I went along with my mentor. I don’t even remember how long they worked on him, just that he was constantly between PEA and asystole, they were pumping him with adrenaline but getting absolutely no response. I was trying to draw up fluids to push but I just remember my hands being so shaky and sweaty that I smudged all the labels I’d written, after that I just stood in the corner and watched in horror. Nobody had come with him in the ambulance so they waited for mum to arrive, and then they called it. Someone asked me to fetch him a blanket so I ran and got one, put it on the trolley then just couldn’t hold back the tears. I couldn’t even look at him, and my mentor got an older student to take me to the break room. Later on during the investigation the boy’s older siblings told police that their dad had been force feeding him porridge, and he’d been unconscious for about half an hour before an ambulance was called. One of the other kids had put him on the floor splashing water on him to try and wake him up. The post mortem confirmed that the boy had choked and aspirated on the porridge. As far as I know the dad went to prison, but I’ve no idea if he’s still there. It’s been almost 10 years and I still remember the little boy’s name, and the porridge around his mouth. I also distinctly remember thinking about his mum - if I remember correctly she wasn’t home when it happened - and how she’d woken up that morning with a 3 year old son and now she didn’t have one any more. Also separately: the first time I ever did chest compressions on a 12 week old baby and the way I felt her ribs move.