[jeepgirl]

as a student, i worked part time in onc/pallitive care...

i always talked my dead people as i prepared them. i always told them what i was about to do to them, ect. i think i freaked out one of my coworkers one time though... as we were transferring one woman post code to the morge (sp?) I accidentally hit the head of the bed on the door... so i said, "Oh, "Jane" (not the patients real name - but i did say it when this actually happened), we'll be more careful! I didn't mean to bounce your head like that!"
the other CNA looked at me like i was crazy!!

i don't know if it is healthy or not. but it made me feel better.

[chris_at_lucas_RN]

Sounds very healthy to me. It would be a different story if you were annoyed that "Jane" didn't answer you!

[NeuroICURN]

Originally Posted by Karen30

I think it has been said before, but I'll say it again as it is what I believe. Even with todays technology, no-one can say for certain what "brain dead" or unresponsive patients can and cannot hear, which is why I always chat with any patient, responsive or unresponsive, let them know what the weathers doing, what day it is etc. Maybe future advances in science will reveal those patients who are "brain-dead" can hear, who knows.

As for talking to those patients who have sadly passed away...yes I do it, it's a coping mechanism and enables me to cope with their death and also who knows whether the soul/spirit can hear people? Maybe, maybe not but who knows anything for definite in this day and age?

Ok...it's fine if you say that you're talking to the soul....but what I think that some people are missing is the fact that brain death is NO DIFFERENT than if a patient went asystole!!!!! BRAIN DEAD = DEAD!!! At the point of brain death, a death certificate is issued!!!!!

I can understand why people would be "confused" about if this is really death because the heart continues to beat. However, just because the heart is beating DOES NOT mean they are alive!!!!!

[NeuroICURN]

Originally Posted by chris_at_lucas

If it was me that was the patient, and I could not communicate or outwardly respond in any way, I'm sure I would be seriously anxious (meds notwithstanding) and probably a bit ticked off.

If someone talked to me like I mattered, if someone reassured me that they cared, that might be all I could get. And compared to nothing, that would be quite a lot.

If you have anxiety or were aware of anything, then you would NOT be brain dead!!!!! That is a TOTALLY different story; I talk to comatose patient's all the time.

Brain death = completely DEAD!!! Please see my previous post.

[chris_at_lucas_RN]

For me as care giver, who am I to say where consciousness ends? The fact is we have "known" so much that has turned out to be wrong. Makes me think of that old starfish washed up on the beach story: I cannot save them all and maybe it doesn't matter on the grand scale one way or another, but to the one I am helping, to that one it means quite a lot.

If I care about my patients, then while they are in my care, nothing matters except how I treat them.

To me it is not about science at all. But it is hugely about nursing.

I do think you are missing some points here, NeuroICURN. We have asserted that just because someone is "brain dead" according to whatever technology there might be, now or at some point in the future, this does not mean that there is absolute certainty that the individual is not aware, at some level.

That is what I was responding to and what others have shared here. Please let's try to keep the tone of this thread on an "up beat."

Like I said in the portion of my post I quoted above (emphasis added), it is hugely about nursing.

[DianaJH]

Originally Posted by chris_at_lucas

I do think you are missing some points here, NeuroICURN. We have asserted that just because someone is "brain dead" according to whatever technology there might be, now or at some point in the future, this does not mean that there is absolute certainty that the individual is not aware, at some level.

That is what I was responding to and what others have shared here. Please let's try to keep the tone of this thread on an "up beat."

Like I said in the portion of my post I quoted above (emphasis added), it is hugely about nursing.

I have to say I agree here. It wasn't that long ago that there was a woman on Oprah with a small girl who was born and died and she had been holding the child for, I think, an hour and the baby started breathing. This baby had been tested and brain dead, etc. When reading the original post of this thread, my thought was that although modern medicine can say a person is BD, they have no clue about the soul and readily admit that. Too many statements by the medical community over the years have been found to be false as technology advances. The opinion of the medical community can be that brain dead is dead, but there is no way to know for sure in the respects of what a patient can hear since they have no answers for the soul. It can't be carved in stone. The thread was about what they hear when you talk to them, not what the clinical definition of dead was.

[NeuroICURN]

I stand behind my responses. If you reread my posts, I stated that if she was talking to the soul, then I felt that that was fine.....If that is what someone needs to do to deal with the current situation, then fine, I'm all for it. I merely stated a fact....that at the point of brain death, a death certificate is issued.

However, the point that I was making was that MANY people do NOT realize that brain death is the equivalent of death where someone is asystolic. People sometimes have a hard time realizing that someone is dead, just because the heart continues to beat.

After all, isn't this what this post was about??? It wasn't about talking to living people, it's about talking to DEAD people. I'll state it again, I talk to my comatose people all the time and encourage my families to do so. My responses are based on my personal experience. I work with this stuff, day in and day out.

[gwenith]

Although the term "brain dead" in ICU and especially in NeuroICU refers to a specific and leagal defintion of death it is a term that is sadly misused. We hear all the time of people diagnosed as "brain dead" but in fact the tests that determine this state were either never carried out or the patient did not fit the criteria.

I have even used the term "brain dead" to refer to myself after night duty!!

However there is one point I would like to refute in the ascertion that "dead is dead". Unless an EEG is used in the test criteria then all we are determining is brain stem death NOT full cerebral death.

Why do we only test for brain stem death???

1) I wouldn't want to be the patient trapped in a mind with absolutely no outlet and
2) death from asystole will occur within 1-3 weeks of brain stem death. The mechanism is unknown

The underlined portion of my text is from Oh's Intensive Care Manual by Dr T.E. Oh. fourth edition Butterworth's Sydney (Sorry if I have any part of the reference wrong I am doing it from memory)

[nckdl]

I was rereading previous posts and, after my father was declared "brain dead" by the neurosurgeon, the vultures (nurses) swarmed my mother with requests to eliminate the ventilator, that we are making him suffer, and that we needed to get a grip because he was soon to be dead, All before the neurosurgeon had actually done any tests to prove he was unconsious and not brain dead. Yes, i know i called the nurses vultures, even though i am a nurse, but to me at that time, that is what they were and it felt like all they wanted was the bed free. I realize now that dr. shouldn 't have spoke to us about brain death before doing the tests, and I think the nurses should have taken our concerns about my father when we said He moves his head back and forth everytime we talk to him and they say, oh you are just imagining things because he can't do that. Some hospitals are more like bandaid stations. And my father said after recovery to "never send me to that hospital again". So i'm wondering what else besides the family talking to him, did he hear while being unconsious?????

[earle58]

Originally Posted by nckdl

I was rereading previous posts and, after my father was declared "brain dead" by the neurosurgeon, the vultures (nurses) swarmed my mother with requests to eliminate the ventilator, that we are making him suffer, and that we needed to get a grip because he was soon to be dead, All before the neurosurgeon had actually done any tests to prove he was unconsious and not brain dead. Yes, i know i called the nurses vultures, even though i am a nurse, but to me at that time, that is what they were and it felt like all they wanted was the bed free. I realize now that dr. shouldn 't have spoke to us about brain death before doing the tests, and I think the nurses should have taken our concerns about my father when we said He moves his head back and forth everytime we talk to him and they say, oh you are just imagining things because he can't do that. Some hospitals are more like bandaid stations. And my father said after recovery to "never send me to that hospital again". So i'm wondering what else besides the family talking to him, did he hear while being unconsious?????

what a horrible experience for you and your father. sadly yes, these situations have happened but thankfully they are the exception and not the rule.

i'm very pleased to hear your dad is ok.

leslie