As a nurse, when in your career, and how did you deal with the first patient that passed away? How or did this impact how you cared for patients afterwards?

When I first got into nursing school, my goal was to work in pediatric oncology as well! I have since become a charge nurse in a psychiatric hospital which may seem like the complete opposite direction as originally intended, but if you think about it- the most vulnerable populations are children AND the mentally ill. I haven't actually witnessed any of my patients' deaths, but I've walked in on one who was almost a code after they had attempted to strangle themselves with socks in a bathroom, and I've recently learned of a longtime patient's suicide following discharge.I also have experience with hospice care- as a former volunteer, and more recently as the family/friend of several loved ones who received hospice care... The death of a patient is heartbreaking, especially the first one, but I think, even after years of experience caring for the those at the end of life, it's important for nurses to continue to feel some level of sadness each time- it makes you human, and may also be a comfort to the families to know that their loved one was truly cared for (when my best friend opted to start hospice, her doctor called me because I was her power of attorney and caregiver... The doctor actually began to cry on the phone, and it meant the world to me at the time- still does). When you choose a specialty- like pediatric oncology, or hospice- death may be inevitable, but remember, you have the opportunity to make the journey more bearable, and even beautiful. I have so much respect for nurses who choose to work with the terminally ill and I commend you for considering it for yourself.... My advice would be to volunteer with a local hospice- it's been years since I volunteered, but I remember going through something like 6 weeks of classes (once a week) to learn all the stages of death (denial, anger... acceptance, etc), bereavement, and even funeral planning. It's a great learning experience, and will give you a unique insight into the process. Good luck to you!

I have been a nurse for 2 years and, before that, was a CNA for 10. My first death experience happened the first time I stepped on a nursing floor as a CNA. Since then, I've dealt with the deaths of many beloved residents and many patients. Death is scary when you start in nursing. As a society, we don't discuss death or our wishes towards the end of our lives. My experiences have really shaped how I approach patients and families, especially near end of life. I now work in ICU, so death is usually knocking for our patients. Regardless of the decision to continue intensive care or to transition to comfort measures, I always treat my patient and their family like they are my own. The biggest struggle I see is family members having to decide whether or not to withdraw care. This is when compassion and education is pivotal. Recognizing and acknowledging the patient or family's struggle helps validate their experiences and education helps them make an informed decision. The last thing I like to do is to expand the care team to include palliative care and spiritual care. I know I may not have all the answers or even the time to attend to the needs of my patient or their family. Palliative care is a great resource to educate on how care progresses with comfort measures. Spiritual care helps ease the spiritual crises patients and families feel, even if they are not religious (I personally feel chaplains are our most underutilized resource).

Death is a scary thing for our patients and their family, but through compassion and education we can help ease the decision burden. Early discussions on patient wishes is crucial to ensure they understand what "do everything" means and to meet their care and life goals. Utilization of your resources is also helpful and can help patients and their family understand their options and come to peace with their decisions.

I hope this helps!