Running Head: REFLECTIVE JOURNAL 1

Reflective Journal One: Death of a Patient

Trent University

Erin Power
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Reflective Journal One: Death of a Patient

On January 19, 2018 for the first time in my nursing career my assigned patient died. The

death was expected, as the patient was receiving end of life care for a few days. I had just left the

patients room. I had done a head to toe assessment on him, his vitals were within a normal range.

I went to answer a call bell for another patient, when I returned I was not expecting to come back

to the news that my patient had passed.

Looking back at when my primary nurse told me that my patient had passed, I feel

conflicted as to my response. I said the nurse “Oh really?!”, with excitement in my voice. I was

looking forward to learning about the process of postmortem care, but at the same time this

man’s life was over. His family will not get a chance for another hug, or to hold the warm hand

of their loved one. The world will really never be the same now that this man had passed. Yet at

the time I was completely okay with this. I was looking through the view that this man so no

longer in pain or discomfort, he would be able to rest now.

Going through the process of pronouncing the death I remained very calm. I knew the

process, listen to apical pulse, listen for breath sounds, and check for pupil response, however

actually going through the process seemed somewhat surreal. My mind played tricks on me.

While I was listening for a heartbeat I could see the chest rise and fall as if he were breathing,

but I knew he was not. Tears filled my eyes as I looked at the primary nurse and said “time of

death 1515”. That was the only sadness I had felt during the experience. I kept telling myself that

this was a good thing that this man passed; from my personal experience with family members
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passing I saw them suffer through illness, which is no way to live. It was not until I got home

that day, laid down in my bed that it hit me. My patient had died, and I had cared for that person;

I just let myself get teary eyed and reflect on my day.

The nurse I was working with was very comforting. She told me how working with death

becomes easier, especially when it has been a long time coming. She did not show any sadness,

perhaps which is why I did not allow myself to be sad at the time either. While I know that this

death was for the best, as the patient no longer had to live in pain, I wonder if I am already

becoming jaded this early in my career. On the other hand, I did not know what to expect and I

was not looking forward to this first experience, so maybe my odd way of coping was to act like

I do with all of my other first nursing experiences, be excited because I was learning something

new.

Never in my nursing student career had I been taught the criteria to pronounce a death,

nor what post mortem care entailed. Going into my palliative placement I felt somewhat under

prepared. Professors and clinical instructors have been great for teaching the theory behind

practice and demonstrating clinical skills, however what nursing student mentors tend to miss is

the teaching of when to expect death, how to care for the deceased, and how to handle your own

emotions (Huang et al., 2010). Our schooling thus far has been mostly preventative and curative

measures. Going into the palliative unit I knew that there would be death, yet I wasn’t able to

really prepare myself for it, despite thinking that I was.

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According to Barrere, Durkin, and LaCoursiere (2008) when BSN students receive end of

life care education, more positive attitudes towards care are developed. With this positive

attitude, students do not dread or fear death in their patients, which results in a better therapeutic

relationship, and less moral distress for the student while learning to cope with such matters.

While I believe that education would be important within the curriculum, I do not believe that a

lecture or text book reading would be able to prepare me to care for a deceased person. I think

that it is an experience which you will only understand once you have been through it.

The next time I have a patient who passes away I believe that I will be more open and

comfortable with my emotions. It was not that I was trying to hide my emotions in this instance,

I think that it was more so that I was not able to process what was going on until later on.

Debriefing is an important part of nursing, being comfortable to express yourself with peers in

vital. In all I am glad that I got this experience early in the semester. I will be able to apply what

I have come to understand from this situation and apply it to the next. Allowing myself to be

vulnerable at the time will be more beneficial than when I get home where I am unable to discuss

what had happened with those around me.

This patient had an advance chronic illness, and would never be able to recover from it.

He was receiving large doses of narcotics just to keep him comfortable. While this death was

positive, as he would no longer live in constant pain, it is still devastating to think that the world

will never be the same, no matter how big or small the impact. Showing emotion as a health care
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provider does not make you weak; it shows that you are human and that you care about the life

of your patient.
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References

Barrere, C., Durkin, A., & LaCoursiere, S. (2008). The Influence of End-of-Life Education on

Attitudes of Nursing Students. International Journal Of Nursing Education

Scholarship, 5(1), 1-18. http://dx.doi.org/10.2202/1548-923x.1494

Huang, X., Chang, J., Sun, F., & Ma, W. (2010). Nursing students’ experiences of their first

encounter with death during clinical practice in Taiwan. Journal Of Clinical Nursing, 19(15-

16), 2280-2290. http://dx.doi.org/10.1111/j.1365-2702.2009.03090.x