Perhaps you lost a patient or two during your clinical rotations. Or maybe you skirted the issue altogether and now depending on where you work, you may or may not be likely to experience this soon. Almost everyone has experienced the death of a loved one or a pet. If not, they have experienced a deep sense of loss of some sort and have an understanding of the hurt and pain.

Whatever your prior experience, losing a patient is never easy and takes on many different possibilities for conjuring up emotions. Was it a sudden and unexpected event in a young patient such as an arrest? Or was it a teenager who entered the ER via ambulance from a horrible traffic accident? After working on him for nearly an hour, your team had stabilized him and then he suddenly arrested. Or was it the little old man with CHF who's been a frequent flier since his wife died a year ago? You just met him, but he reminded you of your grandfather and you often found yourself sitting with him on your breaks. Perhaps it's an elderly woman you'd only just met yesterday, but you bonded quickly.

Each of these scenarios evokes images and emotions that represent different levels of loss and can include your feeling inadequate or questioning your faith; the same as they would if the loss had been a loved one of your own. Your patients and your profession are all part of who you are. Death will always take a personal toll.

The first time will probably surprise you because it hurts so much and because of how long you remember this day and the events. Expect it to hurt and you'll be better prepared to face it and help the patient slip peacefully from this world and help his loved ones cope with his death and celebrate his life.