Nurse's Journey: Coping with Patient Loss and Ethical Dilemmas

This article delves into the personal and professional experiences of a nurse who has faced some of the most challenging moments in their career. The author reflects on the loss of patients both in school and later in their career, and the profound impact it had on their emotional and ethical growth as a healthcare provider.

The First Loss: A Patient in Nursing School

My very first experience with a patient’s loss came during my time in nursing school. After a week of preparation, I arrived at the hospital eager to meet a patient who had been scheduled for surgery. Sadly, she never made it to my clinic that morning. She passed away during the operation, an incident that left a lasting impact on me. Through the guidance of my clinical supervisor, I learned valuable lessons about processing grief and coping with loss. Over time, my ability to handle such situations improved, and I came to understand that even in the face of devastating loss, there are always blessings.

Challenges in My Junior Year: Stillborn and Neonatal Losses

The junior year of my nursing program was a particularly challenging time. I cared for numerous patients who faced severe health challenges. However, the emotional toll was at its peak during a stillborn birth story. In a devastating turn of events, a newborn with a life-limiting genetic condition was delivered alive but ultimately passed away within a few hours. The conflicting emotions of hope and despair were overwhelming. It is a stark reminder of the uncertainty and fragility of life.

A Tragic Loss in ICU: A Loved One

One of the most distressing experiences a nurse can face is not just caring for patients but also dealing with the loss of a loved one in the family. This was the case when my son passed away in the ICU. At the age of 57, he was diagnosed with cirrhosis of the liver and was given only two years to live. Over the course of two and a half years, he received frequent paracentesis and other aggressive treatments to manage his symptoms. The ICU setting presented a stark contrast to the caring and compassionate environment of a regular nursing station. Treatment became more focused on sedation and comfort, which at times seemed to hasten his end.

Retrospective on Nursing Ethics: From Palliative Care to Intensive Care

Reflecting on my career journey, I also pondered the ethical challenges faced in modern healthcare, particularly in the context of end-of-life care. During my nursing days, as I prepare for my retirement, the approach to end-of-life care was largely focused on palliative measures, such as hydration and comfort. In contrast, the ICU setting often prioritizes aggressive interventions, sometimes leading to unintended consequences.

Case in Point: Treatment Decisions for My Son

When my husband and I received the call about my son’s condition, I was devastated. Upon arrival, he seemed briefly aware of our presence but quickly became unconscious. The medical team was administering a regimen of 12 IV medications, some of which were highly sedating. I expressed concern about the side effects, knowing that his liver was failing and unable to process the medications properly. These drugs, including morphine and fentanyl, built up in his system, potentially hastening his death.

The clinical staff explained that the sedatives were necessary to prevent the patient from pulling out the tubes, which they believed would cause more harm than good. However, the prophesied prognosis of imminent death was uncomfortable, and the use of such aggressive treatments left me questioning the ethical integrity of the medical team. The Oath of Hippocrates, emphasizing the principle of "do no harm," was particularly poignant in this context.

Conclusion: Reflections on growth and resilience

Through these experiences, I have learned the value of resilience and the importance of seeking support and understanding when faced with such profound losses. The emotional toll of caring for patients and the ethical dilemmas encountered have shaped me as both a nurse and a human. My story is a reminder of the emotional and ethical complexities inherent in modern healthcare, and the importance of always striving for compassionate and ethical care.