Have you watched another person die?

[Endocarditis]

Today was my 1st day in the ER as a student doctor. It's my first year in the actual hospital and I have been just learning the ins and outs of taking a patient history, physical examination and applying the knowledge I learned.

Today I was just expecting orientation and a tour around the ER then I thought the attending would let us out early. Instead, my colleagues and I were thrown right into the action. My first task was to take an H&P (history and physical) of a patient but she refused to talk to a student doctor so after a few minutes of standing around, the attending got a call over the loudspeaker to the Resus unit. He told me to follow him there to see the patient.

For those who do not know what the Resus unit is, it is the part of the ER that is reserved for those who are in the most critical conditions. Upon entering the small room enclosed only by curtains on each side, I see one nurse and another more junior doctor trying to stabilize the patient and get an ABG. Within the first few minutes, the attending receives the ECG and asks me to tell him what I see. The patient has a heart rate of 128 and AF with right axial deviation. He tells me he is going to give the patient Furosemide to decrease the pre-load on the heart and he then talks through medical management of patients with atrial fibrillation. As he prepares to put an IV cannula in, the patient turns cold and becomes unresponsive. The next step was to get a BiPAP machine to hyperinflate the lungs to squeeze the heart to possibly try to increase contractility (Starling mechanism). The BiPAP machine gets wheeled in and as the nurse and doctors are trying to put the mask on, the patient turns white. The two doctors start CPR and yell at me to time 2 min intervals where they re-assess vital signs. I'm completely frozen at this point and don't really know what to do, so I just stand there. 3 more nurses and 3 more doctors come in to try to resuscitate this patient but after about 5 rounds of CPR, the team leader calls it and records the time of death.

After everyone disperses, the attending comes up to me and asks me if I'm alright. I say, "yeah." and I continue to help with rounds for the next 3 hours. I was fine until a few hours ago when I started thinking about what happened so I drank a glass of wine, almost threw up, and now my left hand is shaking.

TLDR: I saw a patient die on my first day in the ER.

Have you ever seen a person die? How did you feel?

For those who have seen a person die, how did you deal with it?

 

[Joe Wong]

I've seen family die. CPR being applied to no response.

Seems like you're in the wrong field man. You can't take that stuff home with you.

My brother works in that unit and tells of some sad stories. How he can do it is beyond me.

 

[GracieNutHugger]

Why were there so many doctors there? I count 4 docs (plus one student) and 4 nurses, seems excessive.

To answer your question, yes, I have seen a couple people die. I had no connection to them so my responses have been pretty mild.

Death is a part of life, accept it, grieve (if you knew the person), and move on.

 

[Wrath621]

Yes

 

[Minnja]

Seems like you're in the wrong field man. You can't take that stuff home with you.

I'm sure many students feel like that the first couple of deaths that happen. Over time I am guessing it becomes a regular thing and easier to handle.

 

[AznCezi187]

No and I don't want to.

 

[drstrangelov]

I worked in the er for a couple years, I saw people die a couple times a week during that stretch. If you're their doctor, having to talk to the families after, I'm sure it's gotta be pretty aweful. The most difficult were pediatic patients, for everybody. The biggest mess I saw was a propane tank explosion, one of those big sons of bitches for home heating. The worst I can recall was a young guy who shot himself in the head, for whatever reason the distraught father came right at me to grieve, around 3 or 4 am, I had no idea how to act.

 

[Josh]

I've seen a lot of people die, and I've often been the one to have to tell a family that we're stopping resuscitation efforts.

Ain't no thing, I'm fine with people dying, we all do it. The more interesting the death, the cooler it is imo. Had a guy crushed under a tree the other day. He was cold when we got there, but it was a pretty wild way to die, he wouldn't have seen it coming.

Your skin will thicken. Hope so anyway, or you're out a lot of loot.

 

[jmag]

I was getting fire fighting standards years ago which included emt training, and saw an old guy passing away in the hospital while they did cpr. It was sad but seemed natural. To see a younger person pass would have been different I think.

When I was riding with fire rescue, the only calls we had were some old people with exhaustion, etc. They said if I had been there two days earlier, I would have been called to a gruesome suicide. The guy cut his wrists and immolated himself in his car. I don't regret missing that.

 

[Endocarditis]

Why were there so many doctors there? I count 4 docs (plus one student) and 4 nurses, seems excessive.

To answer your question, yes, I have seen a couple people die. I had no connection to them so my responses have been pretty mild.

Death is a part of life, accept it, grieve (if you knew the person), and move on.

1 anesthesiologist in case we needed to intubate
1 resident
1 attending
1 team leader

One nurse was calling the time because I was just standing there and the others were helping with chest compressions because it is pretty hard work if you are just doing it yourself.

 

[cottagecheesefan]

I am a nurse and have seen a number of people die. But none in an ER situation like that. These people had DNRs and simply expired. Death Rattle breathing FTL

 

[Terror Zone]

You know it.

Saw several people die when I was an EMT.

Seen it happen under other circumstances as well, I keep those stories to myself.

 

[Fedorgasm]

I've never actually seen anyone die. I usually set up some kind of elaborate device that will lower them into acid or push them slowly into a giant saw blade. Then I tell them in great detail about how I plan to take over the world, then I just walk out of the room and leave them there to die. This has come back to bite me several times. I really should stop doing it that way, but the heart wants what it wants.

 

[Skydome]

You know it.

Saw several people die when I was an EMT.

Seen it happen under other circumstances as well, I keep those stories to myself.

Now i'm interested

 

[Endocarditis]

I've seen family die. CPR being applied to no response.

Seems like you're in the wrong field man. You can't take that stuff home with you.

My brother works in that unit and tells of some sad stories. How he can do it is beyond me.

I've seen a lot of people die, and I've often been the one to have to tell a family that we're stopping resuscitation efforts.

Ain't no thing, I'm fine with people dying, we all do it. The more interesting the death, the cooler it is imo. Had a guy crushed under a tree the other day. He was cold when we got there, but it was a pretty wild way to die, he wouldn't have seen it coming.

Your skin will thicken. Hope so anyway, or you're out a lot of loot.

I feel like it will get easier but I feel like the train of thought of just accepting the inevitable (death) is diametrically opposed to a doctors values outlined in the Hippocratic Oath.

I guess it was harder because the team leader just called it and essentially said it was pointless because her life was not one worth living because she was unable to live comfortably without a person to care for her. She had no DNAR and no immediate family that could be contacted...so the decision was up to the doctors.

 

[Captain Davis]

Like josh, I've seen many. The most recent was a guy in his early twenties who had 4 gunshot wounds. Two in the lower arm and two in the abdomen. We worked him for a few minutes, but he was fading fast. By the time we loaded him into the ambulance, he was gone.

 

[edco76]

Yeah. Paramedic so, I dunno. Maybe 100? Maybe more?

You get used to it. My first code was kinda surreal but TBH, after that its just same old, same old.

Only ones that bother me now are kids or one where I feel like I didnt do something right.

 

[fightingrabbit]

Seen it happen under other circumstances as well, I keep those stories to myself.

Hitman.

I've never actually seen anyone die. I usually set up some kind of elaborate device that will lower them into acid or push them slowly into a giant saw blade. Then I tell them in great detail about how I plan to take over the world, then I just walk out of the room and leave them there to die. This has come back to bite me several times. I really should stop doing it that way, but the heart wants what it wants.

 

[BearGrounds]

I was maybe 9 or 10 when I had the unfortunate experience of watching a man die at my feet from a heart attack. It was an odd experience, watching him fall down and then slip away like that.

 

[edco76]

I guess it was harder because the team leader just called it and essentially said it was pointless because her life was not one worth living because she was unable to live comfortably without a person to care for her. She had no DNAR and no immediate family that could be contacted...so the decision was up to the doctors.

Unfortunately it really is almost always pointless. The last I heard, I believe full arrest survival rates were around 4% I think. I would wager that almost all of those people in their 50s-60s. To be honest I really have only had 2 patients in my 6 year career that I KNOW left the hospital. Sure you will "get them back" a lot. But they always seem to die in ICU later.