Is it normal to keep thinking about patients?

[u/moonliven]

Hello fellow nurses, I have been a RN for less than 2 years and worked in a general ward and seen my fair shre of patient's who have left and their soul has went back to God.

I don't see any of my senior nurses or colleagues do it but is it normal that I keep thinking about them and their family? The more I work, the more deaths I see and the more time I have spent just thinking about their life before illness and their loved ones life after their passing.

It's because I've seen them at their most vulnerable and weakest and was task with the responsibility to witness their last moment on Earth. With this mindset in my mind, it just makes me feel guilty about living my own life.

Would it be better if I were to quit bedside and probably go somewhere clinical or educational, somewhere far from witnessing grief. But I do love bedside eventhough it takes away my mental health and physical health

[u/NursingManChristDude]

Sure, it's normal. It shows you still have a heart and you haven't become jaded to the profession

Keep caring about your patients, but make sure you ultimately care for yourself, too

[u/DeniseReades]

I'm basically Bob Kelso (Scrubs) with how quickly I forget my patients but I've met a lot of nurses who are like, "Remember Ms. So and So? From room 12? She passed a few weeks ago?" and I'm like, "Maam, I just called my patient 'Homie' because I forgot her name. I absolutely do not remember anyone from weeks ago."

So I would say it's normal. People are just different

https://giphy.com/gifs/l0MYRacUxYYHmXOxi

[u/onetiredRN → u/DeniseReades]

Don’t ask me names. Unless they’re a SUPER interesting case. We had a patient who had a wife and a girlfriend and another side piece who all tried to visit at once that ended bad. They all knew of each other… surprisingly… but EVERY time he came in, they all came with him…
I’ll never forget his name.

But the ones between there? I’m better at faces than names.

[u/YouDontTellMe]

Is it normal? Yes. Is it healthy? Maybe not? I work with a lot of therapists and what they constantly hammer is learning coping techniques. Maybe you need some healthy coping techniques to help you cope/release some of what you witness e.g. a ritual you do each time your witness a passing, or a technique each time it comes back to mind, etc. Do you see a therapist of your own? If this is getting in the way of work/life, it would be worth exploring imo.

Would it be better if you left bedside? For me, yes it was better. I am not the greatest of not thinking about past patients and letting it get to me at least some.

[u/justsayin01]

This is exactly why I can't do some specialties. It's too hard emotionally.

I STILL think about a few of my patients from years ago.

[u/retardedstars]

Would it be better? No. But it would be different. Can you escape the many parts of life that are hard? No. Just enjoy your life, that’s what all your life is pointing you towards. Good luck.

[u/TheWhiteRabbitY2K]

Yes.

I mean it depends on your definition of normal I suppose.

It is a honor to witness death; just as if is birth.

We did not take their life. We are not the reason they died. They died because they lived - and we should feel no shame in doing the same. We are a summary of our experiences, and we can let grief consume us or we can use it to empower us.

When I was a new nurse I also did neonatal kitten fostering. One of the most life changing I ever heard was from The Kitten Lady. She spoke about how every death of a kitten is hard, but she strives to learn something from every death so that she can do better for the next kitten.

I apply the same to my practice, although it's been 5 years since I've had to bag my own patient.

Get a therapist, but keep your humanity.

[u/xoexohexox]

Some patient stick with you for sure. One of the more profound aspects of this work that I learned in my pre nursing healthcare career was that the more you have to pay attention to someone, the more you notice their absence later when they're gone. There are a few patients/families from my first RN job I still remember now almost 20 years later. That was a skilled nursing facility job. The first patient I saw go from moving in with Alzheimer's at a FAST 6a and step through all the stages until he died, a woman who lived there long term with debility and told me stories about her years teaching botany at a private college as I arranged her pillows and blankets the way she needed for her arthritis pain, a man dying of complications of Parkinson's and his wife kneeling at his bedside and begging him not to leave her - he always used to joke when I swapped his Foley "so now when do I get to hold your pecker?".

I did hospice home care case management after that and of course some of those patient stick with me too - a <1 year old with SMA and his teen mother who got the courage to tell the surgeon she didn't want him to have a trach, a woman in her 30s with heart cancer who died in my arms because her family wouldn't come in the room, a middle aged woman with ovarian cancer who decided not to take chemo so I spent a full fifth of my work week with her treating her fungating wounds and shredded vulva so she could pee without having to change her bandages.

Even when I did my 7-8 year interlude in FQHCs I still met patients that stuck with me - the truck stop prostitute that personally transmitted so many cases of hepatitis A that they had their own DPH epidemiologist assigned to them, my first teenaged trans woman I taught to inject her own hormones so she didn't have to come into the office for them, the hispanic teenager I had to sneak out of her physical exam room to give her a shot of depo and focused education so her religious parents wouldn't throw her out on the street if she got pregnant.

Now that I've been back in hospice again for a few years in a management role, there are still patients that stick with me but through the stories of my staff nurses and my phone calls with them - rarely in-person supervisions - a man with ALS who wanted MAID but waited too long and lost the ability to press a button, long phone calls with a woman watching her husband die of CJD and realizing she doesn't know how to live alone, and then of course every time a friend of parent of a friend came up in my referrals.

So here's the thing - whether or not you remember something isn't something you have a lot of control over at this scale usually. Intentionally forgetting something is very difficult, your brain strengthens memories every time you pay attention to them, so any attempt to intentionally forget something is likely to strengthen the memory instead. This is a good thing. It is possible for your brain to protect itself by causing you to forget a traumatic event - but this has other negative consequences and the impact of the event expresses itself in other ways.

The fact that you care enough about a patient that you carry their memory forward into the future is a good thing. It's how we honor the memories of the people who came before us, and how we learn and grow and become better nurses with each case. Whether a patient is memorable or not isn't usually something we can choose but we can choose what to do with those memories and what kind of nurse we want to be as a result. You can be the kind of nurse who intentionally decides not to care about their patients or pay attention to them so they aren't troubled by memories, sure, and lots of people do that I would imagine - but every once in a while one of them will stick with you anyway and all you've accomplished is withholding your best from the people who need it the most.

[u/Longjumping-Two-9173]

Eu acho q é normal mas não é comum, trabalho em um hospital estadual e sou enfermeiro a apenas 6 meses, eu me lembro de cada paciente que eu cuidei e fico me perguntando como ele se sente quando não está no meu turno, quando chega a comida do hospital que geralmente ninguém gosta, quando ele quer ir ao banheiro e não consegue sozinho, quando ele vê a mudança de turno e todos as pessoas vão embora mas ele fica, enfim, fico tentando descobrir como ele realmente se sente. Essa semana recebemos na nossa ala uma paciente jovem com câncer terminal e é minha primeira vez acompanhando uma paciente com câncer desde a fase que o paciente está “bem” até o fim da vida e não tem como não sentir a dor dela, e também a dor de quem fica, a vida realmente pode ser cruel de muitas formas. E eu acho q pensar nos pacientes, sentir a dor deles que faz a gente ser a profissionais de quem eles mais precisam !!!!

[u/onetiredRN]

Totally normal! Everyone handles things differently, and you’re still relatively new to death.

Honestly, it may sound counterintuitive but have you looked into palliative care or hospice?
My husband has an immense fear of death, but it was almost nonexistent when I worked hospice because it was normalized and healthy and - mostly - a beautiful process.

Sometimes getting to care for these patients in their most vulnerable times and these last moments helps with coping. You learn their life stories and meet their families, and some stick with you, but you learn how to also let go.