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OPINION

The death of a dog in the night time

  • 10 Comments

‘Nurses deal with death on a regular basis so why is the death of a dog still haunting me?’

I was driving home about ten o’clock the other night. It was a cold clear night and the moon was full. I was on the outskirts of a town in the countryside following another car on my way home.

Suddenly a dog appeared in front of me and I could do nothing to avoid it. Brakes on hard, but no use, the dog went under.

I jumped out. The dog was still on the ground. The owner was upset and apologised, saying it wasn’t my fault.

All in all, it was a bad end to the day. We managed to sort things out, took the dog to the vet, made sure the car was drivable and departed home. Nothing too exceptional, just an unfortunate accident and nothing I could have done differently.

So why is it still haunting me?

I am a nurse and have been involved with death in many forms and have been able to cope, so why am I getting upset over a dog? This has made me think about my role and how I deal with things.

As nurses we deal with different types of death depending on where we work. We have unexpected and sometimes violent and traumatic deaths in A&E, expected deaths in some wards and in care homes. We work in hospices, community and many other places and encounter death much more often than most people. We do what we can and make sure our patients do not die alone even if they have no body else. We comfort clean and care at all stages and personally I find it a privilege to do so. We deal with deaths we find difficult to understand and those we are praying will happen. We comfort relatives and try to empathise and help. I can do that but why is the death of a dog keeping me awake at night.

I think it must be because I feel helpless and could do nothing. As nurses we sometimes feel that I am sure but we do have things we can do. We may not be able to keep everybody alive and at times do not want to prolong the suffering but there is always something. The last thing we can do for our patients is to give them a good death and do our best for them and their relatives. I am sure that all of you can remember a particular death that has made you think of how well you and your team did to leave the relatives with good memories. I certainly can remember some and hope that I can continue to do it in the future.

In the meantime I will just have to work through my problems with the death of a dog whose name I do not even know and learn to cope with things that I cannot control. I suppose it is a good lesson about things that affect us in an unexpected way but I am not sure I completely understand it yet

Nigel Jopson is a support manager for Care UK    

  • 10 Comments

Readers' comments (10)

  • michael stone

    I've been discussing 'behaviour around death' with the DoH for 18 months, and with the Police, etc.

    In my opinion, 'how you feel around a death' is extremely dependent on your own background experiences (and, for professionals, training), and your role 'in the death'. And it is also virtually impossible to 'get inside another person's brain' here - I was involved with 2 deaths a couple of months apart, and during each one, I had 'feelings' which I would have been unable to predict in advance (I'm not a nurse, I'm an 'amateur'), and I cannot entirely rationalise.

    I suspect your problem is that although it was an accident, and beyond your control, you yourself killed the dog - and, because it was a dog, you can't think 'he should have known better'. Also, this was an unanticipated death - it wasn't like waiting for a dying patient to actually die, so for you it was a genuine shock.

    There also seems to be a dignity factor - it is very difficult to accept 'an undignified death' - and being hit by a car, is perhaps hard to deal with (it wasn't 'on the dog's terms', unlike some of the less bad human deaths).

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  • I wonder if we don't actually 'deal' with death most of the time but we are exposed to a fair amount of death and dying. Also our jobs and motivations are predominantly about rescuing, being helpful and displaying a sense of 'in-chargeness', which is the opposite of being in an accident such as the one in this piece. I imagine it would jar at the very least.
    I think there are a lot of resources that help in the processing of this which in our jobs and identity as nurses are often missed or not visible. We are also very used to and probably encouraged to 'cope' no matter what.

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  • The problem you are experiencing is not an unnatural one, this is because it occured outside the environment you are usually used to when dealing with death. Death occurs on a regular basis in hospitals, it is not something you expect to see on the way home. This is why soldiers experience Post Traumatic Stress Disorders more when someone dies after the actual war is ended then when people are killed in the heat of battle. They do still experience the emotional trauma of those deaths but they are trained to deal with them in that situation and environment, not when you are walking down the street. This is a more extreme form of what you are experiencing, but still true in it's own way. It is not an easy event to get over but rest assured you are not alone. I had a pigeon fly directly into my car one morning on the way to work and it was killed instantly, I still get upset by that incident because I had no control of the event. Sometimes though things happen by accident, and that is what it is, an accident and we learn from them. I wish you all the best and hope you can take control again soon.

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  • michael stone

    I agree with the other posters, and will add a couple of points to my earlier post. When I said 'you can't blame the dog' I meant subconsciously - I feel sure, that we all try to 'escape from' upsetting deaths, and there is a lot going on 'under the surface'.

    And re the previous poster's mention of soldiers. I read a book once, in which a WW2 officer described his feelings about his first major battle. He did not have a problem with young men dying, fighting for their countries - but he 'could never become reconciled, to the 'ludicrous poses' of some of the bodies'. There seems to be an ability to accept 'a good death', but part of our brain wishes to deny the death - I'm sure, we want it to look as if the dead person has just gone to sleep. Which, if a guy is hanging half-way out of the turret of a tank, is plainly not the case !

    This discussion interests me - I am convinced that 'death looks different to amateurs and clinicians', but I am also convinced that many clinicians do understand that (and they should be trained to understand that this is fact).

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  • Peter Goble

    Thank you Nigel for posting on this, and for writing in such an open-hearted and open-minded way: although the responses were few they all added very powerfully and helpfully to my understanding, and provoked some worthwhile thoughts that, I hope, will make any future responses by me to unexpected or disastrous death more compassionate and skilful.

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  • michael stone

    Re Peter Goble | 7-Mar-2011 1:02 pm

    There is a slightly different issue, about 'unexpected death' - not the 'psychological aspects', but the way CPR and Verification of Death is currently confused.

    For patients who are dying at home, protocols currently leap from 'expected death' to 'sudden/unexpected death'. This is conceptually wrong - 'expected death' essentially equates to 'a death the GP would almost definitely certify as natural, before seeing the body' and a proper 'sudden' death is one 'the GP would almost certainly be unable to certify, before seeing the body'. Basically an 'expected death' is one the GP has 'virtually promised to certify as natural, in advance of the death'.

    Coroners allow trained nurses to deal with those, in some parts of the country where they allow Nurse Verification of Death. But there are other natural deaths, which 'the GP decides to certify as natural, after seeing the body and deciding if the death fitted the illness' - nurses cannot be allowed to deal with these, because nurses cannot certify death, so they cannot be called 'expected for that reason, and currently they are invariably decribed as 'sudden' when in reality they should be called something else !

    Very annoying - as is the confusion between why a DNACPR Form/Decision exists, and whether a death is 'expected' !

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  • Latterlife Midwife

    I'm a bit late to respond, having just discovered this blog post. May I say what happened to me, at least 15 years ago, if anyone's checking back?

    I was leaving the Delivery Suite after yet another very stressful shift, quite sad and feeling a bit burned out (maybe a lot). I entered the lift and rode down with a young boy in a bed who obviously had just had head surgery. He was not conscious, with bandages encasing his head; his mother and nurses by his side. It saddened me and I knew getting in was a bit intrusive, but I wanted to get home.

    I drove home and a little baby bunny ran across my path. I looked in my mirror to see I had struck the poor thing, right across his head. I was so shocked, but continued home (knowing it was gone instantly) in fits of tears. I would have been upset anyway, but I was stunned by the two events just a half-hour apart, and cried my eyes out.

    The experience stayed with me for years to come, feeling it was deeply significant. This post brought it all back, and it and the comments have helped me process it a bit more after all these years. Thanks.

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  • Latterlife Midwife

    I'm a bit late to respond, having just discovered this blog post. May I say what happened to me, at least 15 years ago, if anyone's checking back?

    I was leaving the Delivery Suite after yet another very stressful shift, quite sad and feeling a bit burned out (maybe a lot). I entered the lift and rode down with a young boy in a bed who obviously had just had head surgery. He was not conscious, with bandages encasing his head; his mother and nurses by his side. It saddened me and I knew getting in was a bit intrusive, but I wanted to get home.

    I drove home and a little baby bunny ran across my path. I looked in my mirror to see I had struck the poor thing, right across his head. I was so shocked, but continued home (knowing it was gone instantly) in fits of tears. I would have been upset anyway, but I was stunned by the two events just a half-hour apart, and cried my eyes out.

    The experience stayed with me for years to come, feeling it was deeply significant. This post brought it all back, and it and the comments have helped me process it a bit more after all these years. Thanks.

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  • Latterlife Midwife

    Ugh, I hate when a posting shows up twice because you forgot to erase it out of the comment box after first putting it up!

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  • michael stone

    To Latterlife Midwife:

    My mum died at home, having been comatose - she died at 8-15 am, and I had agreed to phone her GP when she died, but I wasn't sure if the GP arrived for work until 9 am.

    When I phoned the surgery, at 9, it turned out the GP had taken the Friday off as the start of a long weekend, the receptionist told me to call 999, and stupidly I did so.

    I had serious ensuing problems with 999, who couldn't get THEIR heads around the fact that watching someone dying from a coma is not 'an emergency' (a complete dog's breakfast of protocol non-alignments didn't help), but I am absolutely 100% convinced that 'how you react to a death' depends on your own personal experiences, and for professionals training.

    You can't 'work out' how someone else will feel, if their experience and role is different from your own - the way nurses are so affected by these 'out of context animal deaths' seems to back me up, in my opinion.

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