I arrived at work this morning after nearly a week off due to personal illness. I felt groggy and not fully ready to be back but not feeling sick enough to stay home. As I drove up the hill towards the stand-alone psychiatric hospital I work at I first noticed the flash of red lights. This isn’t too uncommon, as we are a hospital and incoming patients arrive via ambulance. As I got closer, I noticed there were several police cars as well. The first thought in my mind was that there must have been a behavioral incident, which is commonplace, especially on the psychotic disorders unit. Quickly forgetting about the flashing lights and police presence I parked my car, grabbed by coffee and keys, and headed inside for what I thought would be a quick half-day of work. As I walked towards my office I saw a social worker looking rattled and a patient talking to two police officers in the hallway. I asked the social worker what was going on and she looked at me with lost eyes and said, “She died”. I was so startled by what she said that my thoughts didn’t come out in any coherent order. In a matter of seconds I learned that it was a patient who had died, and that the patient was mine. The feeling I felt then is one I will not soon forget. I rushed to my unit, mind reeling. When I arrived my unit was eerily quiet – all patients had been removed except for the deceased. Staff were scattered about in various stages of shock and auto-pilot. It was quiet – the type of quiet that inevitably follows devastation. Inside each of us was surely burning a sense of fear and confusion. We aren’t a medical facility – this is not a place where patients come to die. I have worked at this psychiatric hospital for three years on the same unit (Co-Occurring Disorders) and though the risk for serious medical incidents due to detox is ever-present, it simply had never happened before. I’m writing this blog post now as a way to process this death. My patient died today. This day, therefore, is unlike any other. There have been times that I’ve learned that former patients have died after discharge – some to overdose, some to suicide, and some to related health complications – but to lose a patient that is still under our roof has altered me in some way that I know will always remain changed. I am changed as a person and clinician for many reasons, as I cannot un-view what has been seen or un-feel what has been felt. I saw the corpse of my patient. I saw my patient wheeled away in a body bag. I saw my patients grieve the loss of a peer. I saw their fear. I saw their intense desire to escape the emotional pain they were feeling – I know that if there were home they likely would have used drugs or alcohol to numb the fresh trauma. I saw my own peers rattled, pale, and heartbroken. I saw nurses on bent knees crying while administering CPR to a patient that was already gone. I saw tears in the eyes of psychiatrists that were quickly blinked away and replaced by a calm façade. I felt myself panic inside as I tucked my emotions away for later and comforted my patients through what was unknown territory to me, but sadly, for some of them it was an all too familiar scene – another peer lost in their struggle for sobriety. At the end of the day, I sit here and wonder to myself – what now? How do I process this event, accept it, and grow from it? If you have any experience with patient-loss please contribute to this conversation, as it’s an important one. How do we as clinicians cope, heal, and move forward after a patient dies?
Post by: Tara L. Martin, MS CTRS
Sheppard Pratt Hospital, Baltimore