Monday, May 26, 2008

Confronting Death

I have just completed a clinical placement in an Intensive Care Setting. On my second day there, a patient was admitted from theatre and I was assigned to treat her with my supervisor. This patient, in their 60's was the victim of domestic voilence and had recieved blunt head trauma and consequently surgery. I walked into the room and was confronted by a patient who had so many facial injuries and head trauma that I didn't even think they looked human. Having read the notes and knowing the backgroud, I still didn't know what to expect when walking into the room. I was shocked and I kept my distance from the patient - I think I felt quite nervous about treating someone so badly injured.

The supervisor helped me a lot with this patient on the first treatment, and then I treated the patient twice a day from then on with supervisor help and feedback when i needed it. At the end of the second day, the patient began to deteriorate quite quickly, the ICP was gradually increasing and there was nothing more the team could do. I was told that Physio treatment would continue as normal. I had treated this patient on my own for a day and i found it very challenging as it was terrible to know that someone could have done this to another person. I tried to maintaing profesionalism and not allow my personal feelings and thoughts out. I felt great sadness and helplessness that i couldn't do anything more. When I arrived the next day, my patient was having a brainstem scan as they thought they may have coned overnight. The patient came back to ICU and it was confirmed that she had died although she was kept on a ventilator for organ procurement.

I was assigned to treat her that afternoon. I performed MHI and suctioning on the patient knowing that they had died and this was the huge challenge that I faced. I felt overwhelmed during the treatment, but I tried to keep it as 'normal' as possible, talking to the patient like I had on previous treatments. I think I did that more for myself than anyone. That night when I got home I had a huge range of emotions from sadness for the patient and their family, to anger towards the person who had done such a thing, and helplessness at us not being able to save her.
Looking back on it now, and having not had to deal with death before, I think I coped quite well.
I talked to my family about it as well as my peers on prac with me. I also let some of my emotions out once I had left the hospital. I realise that everyone did all they could to save her and that it was an aweful tragedy. I suppose it gave me another perspective, seeing this patient in the flesh and the struggle they went through, instead of on the evening news. When I think about that I feel glad that I was able to help in some way.
I think it's important to 'keep work at work' like they say, but for issues like this you need to let your feelings out to a certain extent. I was wondering if anyone has to deal with a death on placement and how you coped.

1 comment:

Ellie B said...

Sophie, I think you handled this really well. When it's a situation of domestic violence it can be very hard to maintain a professional demeanour and keep your feelings in check, but you did and maintained the dignity of the patient. Don't know how well I would have handled it.

I hope you're coping well after this experience.