[LPNnurse]

Yes she was. She had NO brain activity. She died two weeks later. I guess no one person will ever know the answer if they can hear you or not. I like to think in one way they can so you can give ease if needed but on the other hand I like to think they can't because to be aware that you are in that state must be horrible. I understand there are two different conditions and states. I believe most of us do understand that.

Originally Posted by stevierae

Well--WAS she brain dead? That is, was she determined by lack of cortical function to be brain dead? Or serial EEGs? Or whatever the state she was hospitalized in defines as criteria to establish brain death?

Let's all remember that chronic vegetative state and brain death are two very, very different conditions--and there are several "in-between" states we've described in earlier posts in this thread. Some people don't seem to understand the difference in "chronic vegetative state" & "brain death--" -----witness the Schiavo case.

That said, whenever I come upon a fatal accident, or even see a dead animal in the road, for that matter, I always make the Sign of the Cross, (having been raised Catholic) and I also say "Om Mani Pa Me Hung" (following Tibetan Buddhist philosophy, which I also embrace.) Can't hurt--never know if the spirit is hovering in some netherworld, unsure of where to go. I think I'd do the same with a hospitalized patient who was hovering in one of those "in between" states.

[OntCaRPN]

I wasn't thinking in specifics. I assumed the original question to mean ... do we talk to unresponsive patients .... and yes, I do.
The incident I related was regarding a fellow with a brainstem injury.

[LPNnurse]

No worries, it is a wonder of the world.

[stevierae]

Originally Posted by LPNnurse

Yes she was. She had NO brain activity. She died two weeks later. I guess no one person will ever know the answer if they can hear you or not. I like to think in one way they can so you can give ease if needed but on the other hand I like to think they can't because to be aware that you are in that state must be horrible. I understand there are two different conditions and states. I believe most of us do understand that.

I know; I was not talking about you --was referring to all the controversy surrounding the Schiavo case, in which various doctors who had not even seen or examined the woman were making pronouncements of which state she was in--and they all conflicted with each other's. Of course, the non-health care professionals out there protesting had only what the media told them to go by, and therefore were not well-informed--how could they be? They are not health care professionals, as we are, with knowledge of the various "in between" states or those neurological states other than chronic vegetative state and brain death.

[OntCaRPN]

News stories like that just make me sad. We teach and teach our little hearts out and then along comes a media mess like that one! it's soooo disheartening.

[Anthonyshamoun]

Dear talaxandra
i am a clinical educator at a medical center in the middle east, i got interested with what you mentioned about addressing brain dead patients.
based on my experience in this field(i have a 4 year experience in ICU) i guess that RNs possess great knowledge about the patient's conditions though they keep talking to him/her if he/she is brain dead.
i used to do that and still doing it when i have the chance. You should keep in mind the cultural variations with respect to such matter.
Have a nice day

Originally Posted by talaxandra

I'm about to begin a Masters research project about ICU nurses talking to brain-dead patients (oh the joys of ethics approval committees!). My interest in this started when I read 'Rethinking life and death' by ethicist Peter Singer - he described observing nurses in ICU talking to brain dead patients as though they were alive, and from that decided they did it because they didn't understand that the patients were clinically dead.
I think that nurses who talk to their brain dead patients do it for a variety of reasons, which may included (but are not limited) to issues about reconciling the apparently living body (sensory knowledge) with knowledge about brain death (intellectual knowledge). I don't work in ICU, though I do work on a nero unit; I always talk to the unconscious, and sometimes talk to patients who have died.
I was at a conference in the UK last year, and an ICU nurse educator said that she not only never talks to brain dead patients, she corrects any students who do. However, one of the anaesthetists there always speaks to his brian dead patients. They're ruining my research!
What do you all think? This isn't something that will make it into my thesis, BTW, but I'm interested in what you think about the project idea, and about your own practice.

[dgudmestad]

I bathe dead people......why shouldn't I talk to them, even if only to hear the hum of my own voice. Doesn't really matter either way.

Originally Posted by nckdl

This past january, my family was told that my father would never "wake up" after having a quadruple bypass. The neurologist said it was a lost cause and the icu nurses told my mother that we should consider pulling the plug and i did not once see them talking to him, until....... we kept talking to him for hours and hours every day and low and behold he AWOKE. My my, that was a quick trip from brain dead to alive and well huh!!! To make a long story short, Doctors do not know everything, and we as nurses should make a point of ALWAYS talk to the patient, no matter what the condition. And yes, my father remembers hearing voices and could recognize our voices but could not really understand what we were saying.

[psalm]

...I talk to the pt. and I talk during postmortem care. I do this with family present and/or with nurse aide or new nurse AND when I am alone as respect to this person who has departed this life. Also, when I was a new nurse it helped ME thru the death of my pt., to focus on her needs. My job doesn't stop with the last beat of the heart.

[ptadvocate81]

Originally Posted by talaxandra

I'm about to begin a Masters research project about ICU nurses talking to brain-dead patients (oh the joys of ethics approval committees!). My interest in this started when I read 'Rethinking life and death' by ethicist Peter Singer - he described observing nurses in ICU talking to brain dead patients as though they were alive, and from that decided they did it because they didn't understand that the patients were clinically dead.
I think that nurses who talk to their brain dead patients do it for a variety of reasons, which may included (but are not limited) to issues about reconciling the apparently living body (sensory knowledge) with knowledge about brain death (intellectual knowledge). I don't work in ICU, though I do work on a nero unit; I always talk to the unconscious, and sometimes talk to patients who have died.
I was at a conference in the UK last year, and an ICU nurse educator said that she not only never talks to brain dead patients, she corrects any students who do. However, one of the anaesthetists there always speaks to his brian dead patients. They're ruining my research!
What do you all think? This isn't something that will make it into my thesis, BTW, but I'm interested in what you think about the project idea, and about your own practice.

I work in SICU, and unfortunately I see quite a few brain dead patients, and yes, I always talk to them as I would a regular patient. Why? I have found that it is comforting to the families to hear you talk to them as though they are still with us, and I figure the only way to remember to do that during the brief visiting hours is to do it all the time. Besides, no one really knows where their soul is during this time...

[Jessy_RN]

Originally Posted by MandyInMS

I always talk to unresponsive pts..because even with the technology we have today, the mind/brain still has much that is NOT understood..so I always explain what I am going to do with/to them..treat them as if they CAN hear/understand me..how many times have you heard of a pt who was in a coma/brain dead that has eventually 'come back' and recalled many things..not often..but on rare occasions..I'd like that pt to remember staff/family talking to them and treating them respectfully..that's just me

You are definetly right, there is so much we don't know, so it serves to "just in case".