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We having a patient who declined quickly she was in a wheelchair threatening to cut my wrists at one minute and the next she was on hospice in a bed on oxygen and when we came to work today she had passed away 😢


Dealing with this has been hard on me mentally and I'm looking for advice!

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Stephanie, please tell us more about what is worrying you. Is it the possibility that your patient has been treated inappropriately and this is the cause of death? Are you concerned about how hospice has treated her, and is this a one-off or a repeated concern? Have you asked for more information from the ‘hierarchy’ where you work? This experience sounds worrying, but advice depends on more detail.
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Quick decline is common if the patient is elderly.  A stroke or heart attack can happen, or pneumonia can take them.  Did she have a DNR?  Did you ask the head nurse what happened?  Some reading about end of life may help.  It helps also to know about letting go.  Ask others working there how they deal with it. 

It helps me to believe the spirit continues.  Long ago I read "Life After Life?"  by Raymond Moody.  Moody interviewed 150 people who had undergone near-death experiences (NDEs). The book presents the author's composite account of what it is like to die.
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The reality is that almost all of the people who enter a long term care facility will die there, as I watched the people living around my mother pass away I concluded that had to be one of the hardest realities for those who worked there. It sounds as though the poor thing was anxious and confused, a swift decline was a mercy. Teepa Snow has a video I found helpful

https://www.youtube.com/watch?v=mNJxq4J5kYY
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As a nurse, I have seen many patient's pass away through the years. I try to make sure that if no family or friends are there, I stay in the room with them, talk to them and hold their hand. I don't think anyone should have to leave this world alone. It makes me feel better to know that their last days or months were better because I was there with a smile, some comforting words, empathy and compassion.
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Stephanie, you sound like a very caring person, exactly the type of caregiver that those of us who have loved ones in nursing homes pray for. Was this perhaps the first death there you’ve encountered? I know it must be terribly sad sometimes to care for people who you watch slowly decline. My Mom was in a NH for 2.5 years and I got to know not only the aids and nurses but some of my favorite residents. And I witnessed the sadness that the staff endured when some of these residents passed away. The week my Mom passed, 3 other residents passed quickly after. I was there multiple times that week, and everyone on the floor was so sad. We all hugged and consoled each other, but they had to carry on, and be cheerful and pleasant to the other residents. I give them so much credit. The best case was one little spitfire lady who was perfectly fine at dinner, passed away in her sleep. The rest of us were not so lucky. I’m sorry that you’re upset about your lady’s passing, but I hope you take some comfort that her decline was quick. Boy, that’s how I want to go! All you can do is the best you can while you’re there, and treat them with compassion. You are working in their house now. Best of luck to you.
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My daughter is a RN and worked in rehab/nursing for 20 yrs. She says u can't help and have your favorites. She has left the building many times to cry and have a smoke. Not sure if you ever "harden" yourself to people dying but as you age it gets easier to except it. It happens to us all sooner or later. If ur working in LTC, then your residents are on the way out. Its usually a blessing. I believe there is something beyond what we know. I believe you become whole again, no pain no confusion.

Be happy in knowing you did what you could for this woman. You were kind and patient and respectful. You may have been a bright light in this woman's day. In your career this will not be the last person who will pass on. Let yourself cry for them, then go on.
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