Monday, February 06, 2023


 I deal with death more frequently than the average person. I have no problem with dead bodies. I am respectful when doing post-mortem care. I've learned to cope with the emotional aftermath. But this is the first time in my career that I, the RN taking care of the deceased patient, not only pronounce death (with another RN verifying), but I am also the person who calls the loved ones and notifies them of the passing. 

I count myself as a good communicator, with more-than-adequate interpersonal skills. But I have to tell you, awkward doesn't even begin to describe the first such conversation I had with a deceased patient's family member. The only things that were in my favor: the death was expected, and the notification was over the phone, as the patient's son lived out of state. I am already mortified (no pun intended!) just remembering the phone call. The thought of having had that conversation face-to-face...? 


Well, I try to look at it as a learning experience, and an opportunity to grow more skills in my field. Also, looking ahead towards the end of my career, I'm leaning towards hospice nursing. So I guess any experience is good experience?!

What do you think?


Glypto Dropem said...

First a question; do you legally pronounce death like for the death certificate, or do what we call a "presumption?" In my A.O. we do an on-scene presumption with our med control doc on the phone presenting our findings. The doc then issues the official T.O.D. Last two I personally did were easy. The 1st was in advanced stages of decomposition. The second was a 12 gauge to the center of the chest.

It is the same in EMS. We get a call for cardiac arrest and work the patient on scene for 20 minutes. By then a paramedic has arrived and is doing their advanced interventions. If there is no spontaneous cardiac rythmn at the 20 minute mark, we call it. But it is still a presumption with med control on the phone. The state police are on scene to make sure the untimely is due to natural causes and start the legal paperwork. We on the other hand, inform the family of the passing of their loved one, and provide comfort (and sometimes emergency meducal care) to the family members. We can be on scene for quite a while sometimes. We only transport if we get pulses back, even if we have to do CPR again.

I had a guy one time that screwed big time. His elderly mother was in hospice but he didn't read and then misplaced the paperwork. He could not wake her up so he called 911 before he finally called hospice. That set everything in motion for an untimely death call. I remember the guy being upset that his house was being treated like a crime scene. When the hospice nurse showed up and was informed what had taken place, he just said "bye" and left. This past fall, I advised a friend of mine whose wife was dying of lung cancer about hospice. They took a trip down south for a wedding and when they came back, she started going downhill. We transported her one last time, and they got her into hospice when she came home. She passed 2 days later.

I live and work in the same small town. It sucks when it is someone you know.

Christina RN LMT said...

That sounds really tough, when it's your friends and neighbors! I dunno about death certificates, but literally, the other RN on the pod and I verified that the patient was deceased, called the doc through the answering service (of course, this was night-time coverage, and the doc didn't know the patient at all), and then doc only confirmed it was a "comfort care" patient, aka in-patient hospice, and that was that. I had to fill out a bunch of paperwork, but I don't recall a death certificate. I had to call the organ donor peeps, too. My charge nurse that night was less than helpful. She grabbed this gigantic binder, handed it to me, and said, "Just follow the steps in here." My patient died at 2130, and wasn't wheeled off the unit until around 0200. It's certainly a process. Mind you, I had four other patient to take care of as well during this time.