Losing Your Patients

For healthcare professionals, dealing with death becomes a part of life. While many of us go on to work in outpatient settings, where our exposure to death is minimal, we have all been touched–or scarred–by loss.

You may be an ICU nurse that spends 12 hours a day at a patient’s bedside, a physician that is ultimately responsible for making really difficult decisions, or a chaplain that helps families through difficult times. Perhaps you’re a medical student or a nursing student, developing the knowledge and skills you need to perform your future role. Or maybe your role is less visible to the patient–keeping hospital systems running smoothly, or ensuring that clinical personnel receive critical training.

Whatever your role in healthcare, you play a part in improving–sometimes even saving–lives. When patients get better, we celebrate together.

But occasionally, despite our best efforts, our patients don’t get better. Sometimes they get to us too late, and there is nothing we can do. Sometimes they have diseases we can’t treat. Sometimes we make mistakes.

During my residency, a few of my colleagues and I were asked to speak to students at a nearby medical school who were considering careers in pediatrics. One of the students asked how often we had to deal with the death of a patient, specifically a child. My initial guess was 8-10 times over two years. But over the next half hour, my mental list grew to well over 30. There have been several more since then.

Some of these patients are burned into my memory forever. I know their names, their faces, their parents. Other memories aren’t so clear.

Often, the deaths that affect us the most are the patients we got to know well. The patient who battled cancer for years and finally lost. The child that lived in the ICU for months until he didn’t anymore. The old man whose wife brought him in twice a year for decades, “just to get checked out,” and then died suddenly at home. Out of nowhere.

Sometimes, there’s something about a patient that reminds us of someone we love. These are the hardest for me. On night, as I walked out of the ICU room after a young boy died from a head injury, I noticed that he was born on the same day as my daughter. It could have been her.

After a patient’s death, our experience is different from the family’s experience, but no less real. We feel guilty, questioning all of our decisions and actions. We grieve. We cry. We pull over on the side of the road to get it together enough to finish driving home. And then we go back to work, because other patients need us, too.

Talking about these experiences is difficult. Respecting our patients’ privacy means leaving out important details. And it’s often hard for spouses, family, or friends who haven’t had similar experiences to understand.

One thing I’ve found helpful is writing a letter to the family. I think it means a lot to the families as well. It’s ok to let them know you’re human. I’ve written more of these than I’ve sent, but I’ve sent a few. I never expect anything in return, but I’ve gotten a couple letters back from parents. One of them was hand-written on eight pages of tear-stained notebook paper. Folded inside were baby pictures of her daughter, who had died as a teenager a few weeks before. Her pictures live on in my desk drawer.

As difficult as these experiences are, they can make us better, both personally and professionally. If mistakes were made, we can learn from them.  We can grow as a team because of our shared experiences, so that we can take even better care of the next patient. And we can become better at empathizing with families and providing the support they need.

If you have recently lost a patient, or you have an experience that haunts you from years ago, be sure to get the help you need. Sometimes, it’s enough to just get away from it all and spend some time alone or with those you love most. Other times, you need more support. Talking to other members of the healthcare team, a chaplain, or a mental health professional can be helpful. Never be ashamed to ask for help. Our jobs are tough, and it’s important for you to be at your best–for yourself, your loved ones, and your patients.

  1. Dona Lea Fanning left a comment on 01/04/2017 at 8:02 am

    You are such a special person. You can write your feelings well. I have always been proud of you.

    Dona Lea

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