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It’s already 4 in the afternoon and you can’t believe how fast time has gone today at your favorite clinical placement. Only three more hours left of the shift. Another nurse on the same unit comes by to share that her patient hasn’t been doing well and had a difficult time with her surgery this morning. You take a walk to that patient’s room to assess her together. You feel your heart stop briefly but you can’t understand why. That balloon-like belly looks so familiar, but you cannot recall from where. The patient’s nurse pulls up her chart so you can read through her medical history and ask questions. As soon as your eyes meet her name on the screen, it all comes back to you: you had specifically requested to observe her surgery in the operating room when you were rotating in the PACU last week. 

You remember how small she was and how flaccid her limbs were as the anesthesia team transferred her from the isolette onto the operating table. The procedure itself was as quick as watching an episode of Friends, but you remember how meticulous the team was in ensuring she was stable and safe to bring back upstairs. You don’t stay too long because you must prepare the next round of medications for your own patient assignment, but it was only a matter of minutes until you saw that flash of red in your peripheral vision (the crash cart). Flashes seem to cross your vision as nurses sprint back to the room to draw meds and set the metronome app to 100 bpm for compressions. 

Compressions, pulse check, compressions, pushing meds, pulse check, compressions, pushing meds and blood for a rapid blood transfusion, pulse check. The cycle went on and on. You knew that they were only going to do this for so long, but the question was until when? Consumed by so many thoughts, you try to process everything going on in real time. Suddenly, the current moment hits and you come across the realization that everything has just … stopped. Hands were no longer on the patient, people weren’t frantically moving, and the rhythm strip shifted to a steady flat line. Asystole. The patient has been pronounced dead. 

As a student, you do not experience these situations often. You’re assisting nurses with their cares on a unit for roughly 7-12 hours once a week for 12 weeks’ time. Duties typically consist of learning to critically think about a patient’s condition and practicing your hands-on nursing skills. Seldom are we able to prepare ourselves for the emotional and mental challenges faced with experiencing what it’s like to lose a patient. 

Remember, it’s ok to cry and it’s important to feel. We might try to tell ourselves to be strong, and to hold back tears by focusing on how you didn’t truly know that patient. However, it’s important to avoid this mindset. You can remain strong while also allowing yourself to embrace natural human emotions. No matter how brief your time caring for the patient, you did get to know them in some respect - and maybe their family and friends too. Allow yourself to mourn a lost life, but stay composed to console the family, provide psychosocial support, and provide post-mortem care. Demonstrating respect to the patient and family is your priority. 

Establishing emotional connections with patients is one of the greatest parts of nursing, but in times like these it’s also one of the hardest parts. If you need to cry after your shift or take a minute alone to collect yourself, that is ok. Take the time you need, then leave these sad emotions at the door so we’re not constantly carrying around this emotional weight.  

How can we keep such an emotional weight from negatively affecting our daily lives? The answer: the same way we can separate work from home or coping in general. For some, that might entail going to a mentor, friend, or significant other to share your feelings. Sometimes you need to express yourself to someone with a listening ear to come to terms with what has happened. For others, maybe you just need a night of self-care activities, such as a journaling, taking a warm bath, massage, listening to music, reading a book, or watching your favorite TV show. 

If we let such emotions dwell on us, it can become difficult to continue caring for others. You must take care of yourself before you can take care of other people. You chose to pursue nursing as a career for a reason. Remember that reason, but also remember that there are many paths you can take in nursing. Some people may find that a situation like this has a severely negative impact on their psychological wellbeing – and that’s ok too. If that’s you, evaluate where your best fit in nursing may be.  

One of the beauties of nursing is that there are so many opportunities out there for us depending on our interests – from working with children to working with the older adult population, oncology nursing or rehabilitative nursing, home care nursing, education, management, and the list goes on. It might take experiencing a certain kind of situation to help you realize where you do or don’t wish to work. But wherever you end up, make sure you’re doing something you love – something you’re passionate about. That’s where you’ll excel to be the best nurse you can be and have the drive to provide the best care possible.