First patient death

[DragonClaw]

Maybe, maybe not. At the end of the day, the purpose of bringing this lady home was for the consolation of the family so that they could gather around her at the time (not minute) of her death. Not Monday morning quarterbacking here. When and where she died or even if she died had nothing to do with the call you were on. Neither was "calling it" or not...

Re-reading your post, it wasn't immediately clear to me that you brought the body into the house after she had died, that you had not waited for a hospice nurse to confirm the death before going in. Not the case from what I now read.

I guess even if nobody else notices., As Michaelangelo said while painting the detail of the Sistine Chapel "But I will notice".

I find no shame in our transport but it's a little bitter I couldn't have achieved my desired result.

 

[CALEMT]

you will see all walks of life cut short by death itself.

This. Couple weeks ago ran on a 22 YOM shot in the chest, ultimately coded right as the bird landed, never got pulses back.

I find no shame in our transport but it's a little bitter I couldn't have achieved my desired result.

Unfortunately there are those patients where you'll do everything right and you still won't get the desired result. Case in point what I quoted above. Like others have already pointed out there are few absolutes in this industry. Patients will die and all bleeding stops eventually.

 

[DragonClaw]

This. Couple weeks ago ran on a 22 YOM shot in the chest, ultimately coded right as the bird landed, never got pulses back.



Unfortunately there are those patients where you'll do everything right and you still won't get the desired result. Case in point what I quoted above. Like others have already pointed out there are few absolutes in this industry. Patients will die and all bleeding stops eventually.

I just realized. So I worked a code before. In hospital brought in by FD. For lack of better words

I thought of him as a patient and not a dead body.

After our patient with a DNR had passed, I didn't think of her as the same. She was still our patient yes, but was definitely a dead body. I mentally thought of getting a body bag for a few moments.

Perhaps the difference was the expected or hopeful outcome of each. For her, I only hoped to get her home before and passed. I was under no illusion anything I did would help her live longer.

But the cardiac arrest pt? I hoped for ROSC. We eventually got it. Not sure how well he's doing now, considering the circumstances, but just food for thought

 

[VFlutter]

it's a little bitter I couldn't have achieved my desired result.

Take the personal feelings out of it and do not dwell on what you wanted or expected to happen. In the end it has nothing to do with you or your feelings. Desire to provide quality care and do the best you can in a situation but not for a specific result.

With dying patients we tend to do things for the benefit of others, either ourselves or the families. Prolonged codes, keeping patients on support until aunt carol can fly in, transporting comatose patients home to die, etc. When they are ready, they will go.

 

[VentMonkey]

Take the personal feelings out of it and do not dwell on what you wanted or expected to happen. In the end it has nothing to do with you or your feelings. Desire to provide quality care and do the best you can in a situation but not for a specific result.

1,000 times, this. Glad he articulated it much better than I ever could have.

@DragonClaw I think when others on here question your ability to “hack it” in the field it’s based off of your comments mixed with this reality.

I’m not saying you can’t, or won’t hack it FWIW. We really don’t know you outside of this board.

That said, what he’s mentioned here simply comes with time, experience, and well, mental maturity.

And, sure to some extent we’ve all craved some form or experience by way of another individual’s misfortune. I can’t think of any other way to gain clinical experience.

Once you’ve reached the threshold, you often realize just how selfish you were at times, if that makes any sense?...

Take all of it however you want, that’s ok. It’s not meant as an insult or an attack, but again just my $0.02.

 

[DragonClaw]

Take the personal feelings out of it and do not dwell on what you wanted or expected to happen. In the end it has nothing to do with you or your feelings. Desire to provide quality care and do the best you can in a situation but not for a specific result.

With dying patients we tend to do things for the benefit of others, either ourselves or the families. Prolonged codes, keeping patients on support until aunt carol can fly in, transporting comatose patients home to die, etc. When they are ready, they will go.

At what point do feelings matter? I'm not saying let emotions rule you and be destroyed if something happens. But if you lose heart in the job and feel nothing, is that really better?

1,000 times, this. Glad he articulated it much better than I ever could have.

@DragonClaw I think when others on here question your ability to “hack it” in the field it’s based off of your comments mixed with this reality.

I’m not saying you can’t, or won’t hack it FWIW. We really don’t know you outside of this board.

That said, what he’s mentioned here simply comes with time, experience, and well, mental maturity.

And, sure to some extent we’ve all craved some form or experience by way of another individual’s misfortune. I can’t think of any other way to gain clinical experience.

Once you’ve reached the threshold, you often realize just how selfish you were at times, if that makes any sense?...

Take all of it however you want, that’s ok. It’s not meant as an insult or an attack, but again just my $0.02.

Do y'all really think I'm beside myself unable to cope? I don't get it. I just wished for better circumstances or end result. I think we do that for any patient.

 

[CALEMT]

At what point do feelings matter? I'm not saying let emotions rule you and be destroyed if something happens. But if you lose heart in the job and feel nothing, is that really better?

I don't believe thats what he's trying to say. I love my job, but I also over the years have noticed my lack of emotion and empathy towards certain calls. It's a byproduct of working in this industry. Personally I prefer it, I don't stew on things and I move on to the next call, recognize and treat accordingly.

Do y'all really think I'm beside myself unable to cope? I don't get it. I just wished for better circumstances or end result. I think we do that for any patient.

Again, thats not what he's trying to convey. I'm tired of people on this forum when addressing a post of yours saying "this is not an attack or an insult" he's simply stating past (personal) experiences trying to provide another point of view for you. No one on this thread has said you can't hack it. There's nothing wrong with wishing for better outcomes. Nobody wants their patients to die, but with that said theres only so much I as a paramedic can do. All I hope for is to recognize whats going on and to treat it accordingly. Good patient outcomes are just icing on the cake per se.

 

[VFlutter]

At what point do feelings matter? I'm not saying let emotions rule you and be destroyed if something happens. But if you lose heart in the job and feel nothing, is that really better?

It has nothing to do with losing heart. You can be compassionate and empathetic in the moment without interposing your own personal feelings. Is all this discussion for the patient's sake, or for you? Because for the patient it is over.

Saying things like I wish or I hoped isn't helpful except for trying to make yourself feel better. No one likes not having control over a situation however when you start going down the road of "Maybe if we drove there faster, what if we did this or that" you will not last in this profession. It is not being heartless, it is being rationale.

 

[Akulahawk]

At what point do feelings matter? I'm not saying let emotions rule you and be destroyed if something happens. But if you lose heart in the job and feel nothing, is that really better?

It has nothing to do with losing heart. You can be compassionate and empathetic in the moment without interposing your own personal feelings.

Your feelings do matter a LOT to you, and that's awesome! What a lot of us are saying is that most of us that have been successful in doing patient care long-term is we do NOT take personal ownership of another's problems. We have enough of our own, we don't need someone else's too. Here's an example: I've had an OD patient a couple times. He's had a rough go of things over the past few years and now he's gotten to the point where he knows he has a problem, is trying to fix it, but OD's when he relapses. Am I compassionate and empathetic toward him and his issues? Absolutely! It sucks what he's going through. Now you might think that I'm being cold when I say that it won't bother me at all if he dies before he gets his life straightened out. Here's the reality: I've done what I can. If he shows up at my ED, I'll do what I can. If he codes and I have to work that code, I'll go full-tilt boogie until it's done. Then I don't worry about him anymore. I'll critique my own performance to see if I could have done something better, but otherwise, that's about it. His issues are HIS and not MINE. He'll take the advice and teaching from myself and others or he won't and that's HIS choice. I can't affect him any more than he wants and that's OK because I can only control what I do.

I've been doing this a LONG time. I wouldn't have lasted anywhere near as long if I'd taken personal ownership of other people's problems. So, I don't and I make self-care my #1 priority. As long as I'm OK, I can do my job to the best of my ability. Oh, and no, NONE of this means that I dehumanize my patients and treat them accordingly. If I end up doing that, I've been a bit dehumanized myself and that's not good because then I can't really appropriately act as a patient's advocate when it's needed and appropriate.

Make sense? I hope so.

 

[DragonClaw]

Your feelings do matter a LOT to you, and that's awesome! What a lot of us are saying is that most of us that have been successful in doing patient care long-term is we do NOT take personal ownership of another's problems. We have enough of our own, we don't need someone else's too. Here's an example: I've had an OD patient a couple times. He's had a rough go of things over the past few years and now he's gotten to the point where he knows he has a problem, is trying to fix it, but OD's when he relapses. Am I compassionate and empathetic toward him and his issues? Absolutely! It sucks what he's going through. Now you might think that I'm being cold when I say that it won't bother me at all if he dies before he gets his life straightened out. Here's the reality: I've done what I can. If he shows up at my ED, I'll do what I can. If he codes and I have to work that code, I'll go full-tilt boogie until it's done. Then I don't worry about him anymore. I'll critique my own performance to see if I could have done something better, but otherwise, that's about it. His issues are HIS and not MINE. He'll take the advice and teaching from myself and others or he won't and that's HIS choice. I can't affect him any more than he wants and that's OK because I can only control what I do.

I've been doing this a LONG time. I wouldn't have lasted anywhere near as long if I'd taken personal ownership of other people's problems. So, I don't and I make self-care my #1 priority. As long as I'm OK, I can do my job to the best of my ability. Oh, and no, NONE of this means that I dehumanize my patients and treat them accordingly. If I end up doing that, I've been a bit dehumanized myself and that's not good because then I can't really appropriately act as a patient's advocate when it's needed and appropriate.

Make sense? I hope so.

I do separate myself from the patient. My emergency or the emergency of their family isn't mine. But yeah, compassion is important.

My oldest sister is "your" junkie to me in a way. I mean at first I tried everything to fix her problems. I'd try to advise her. Try to help her. But she doesn't want help and I've resigned myself to the fact that one day she's probably gonna be dead in a ditch somewhere for running with the wrong folks.

Once she decides that she wants help, I'll be there. But not as her physical or emotional punching bag.

I could go on, but I'm saying I understood and agree.

With my patient who died yeah it was a bummer. Who wants her to die so close yet so far? Who wouldn't press a magic button to give her a few more minutes?

But at the end of the day que sera sera. I wish the family the best and move on from it. Keep providing good and compassionate patient care, keep a level and clear head, do my job. That's kind of all I can do.