I Gotta See If He Is Dead!
Family request for a morgue visit, pt had four siblings with learning issues and psychiatric issues. Body in the morgue for 5 days. Major family issues in the lobby, cops called.
I had a strange sense of anticipation as I walked in. Working as a perdiem Nursing supervisor(Assistant Director of Nursing) in a busy hospital, I had strongly felt that I needed to put myself down as available for this Sunday shift a month ago. I avoided working Sundays as they were packed between church,religious education,dance class for my daughter and home cooking. Now I was here.
As I walked into the lobby, two relieved security officers came hurriedly towards me.
"Thank God you are here! We need your help!"
What's the matter Officer Davis? How can I help you?", I calmly asked as I watched the ED social worker turn the corner and come towards me. They all began speaking and I held up my hand and smiled.
"One person please!"
The social worker told me the situation. There was a family in the emergency room. They were very upset. Their brother was missing for five days and they finally found out that he had been brought to this hospital. The doctor told them in the ED that their brother had a major heart attack and had been brought in dead. The family went shocked, angry and upset. There were two siblings in the ER, a brother Tom who was mentally challenged and had lived with the patient and a sister Sara who took care of five brothers, four with special needs (two lived in Ohio) and the patient Ron, who had been brought in dead. She wanted proof that this was her brother. She wanted to see Ronny's body and his belongings.
Our hospital allows patient bodies to be seen in the morgue only under special circumstances. I showed the social worker how to locate his belongings on our EMR and asked him to see if that would suffice. I told him to reach out to me after report.
I got report from the night ADNs who told me flat out that they were not going to the morgue - period! I wasn't hot about it either as the patient had been in the morgue for five days. I prayed that the belonging was enough proof. After report, I was relieved that I was not covering the ED. The other supervisor was!
The social worker reached out to her and was told to tell the family that they could not see the body. The social worker, not knowing what else to do, then reached out to me as the brother Tom was yelling, screaming and having a meltdown in the ED and had been escorted out by security but the family was refusing to leave. I discussed this with the other ADN and offered to go speak to the family. She consented and I went down to the ED.
I approached the sister Sara who was methodically taking out everything from the patient's bag ( which the social worker had found) and looking at them. I offered my condolences and asked her what I could do to help her. She told me that she wanted to see his body and that her other sibling Marcus was on the way.
Tom was sitting outside the main entrance and was not allowed back in for the time being. Security told me that they were waiting on cops.I told them that I would talk to Tom. I slowly went towards him and stood a little away.
"Hello Tom. I am Annie, the nursing supervisor."
" May I talk to you?"
"I am so sorry that you are sad. I wish I could help you".
He suddenly turned, his eyes bloodshot. My heart was in my throat as I did not know what he was going to do!
He burst out, "It's not true! He's not dead! "Sobs racked his body. I inched closer.
"May I sit down?"
He nodded. He thrust his phone towards me, speaking with a lisp, "Look! I called him so many times. He did not answer! He did not answer!"
Tears pricked my eyes. I was looking at a 56 year old who drove a car but had the mental capacity of a five year old.
"I am so sorry! He could not answer you as he died" I said softly. I inched closer to him and now was sitting next to him. He put his head on my shoulders and cried.
After a while he sat up, looked at me and said, "It's ok. It's not your fault".
I saw the cops pull up and I signed that it was ok. They kept a watchful distance. Now that I had got him to calm down I asked him if he would like something to eat or drink. He asked for water and so I went the ADN office and got him Graham Crackers and water. He thanked me! I then told him to call for me if he needed me and went back into the lobby. Sara who was sitting in the main lobby told me that she was waiting on Marcus who had psych issues! I spoke to security and asked them to inform me when he arrived and went on rounds. I got paged two hours later that Marcus was there and was having a huge argument in the lobby.
I went down and spoke to them. Tom had left as he wanted to grieve by himself. Marcus was in my face and Sara was trying to calm him down.
He kept saying, "I gotta see if he is dead!"
I spoke to security in private and we decided to show them the body. I went ahead with security, put on gloves and mask and prepped the body for viewing o a stretcher. We put a screen around the body.We then went back and told them to follow us. I held my breath as they peeked around the screen.Sara took one quick look and said, 'That's Ron!" and walked out. Marcus stood and stared at his brother and said, "He's gone! My brother is gone" and started weeping hard. Security gently escorted him while the other security and I put the body back in the morgue.
We then escorted them to the lobby where they sat and did not want to leave as Ron was there! Sara showed me a phone video she had taken the week before he died. Ron playing with his dog in the park. Ron looked healthy and happy.
I gently suggested that they go home and finally they left. I thanked the team for working together professionally and helping a family with special needs in grief. The cops had long gone. I went home after my shift and listened to my kids arguing and kidding with each other as my husband and I enjoyed our coffee. I felt blessed to be alive and surrounded by life though my heart ached for Sara, Tom and Marcus.
Special need patients and family need extra careful handling and caring in times of grief. The situation could have escalated if not for the team working together as one. We could not save Ron but we stood together to help his family.
About spotangel, BSN, MSN
Nurse, teacher, administrator enjoys work,enjoys family, try and give my best every time, everyday.Blessed to be a nurse 28 years!
Joined: Mar '12; Posts: 209; Likes: 842Mar 27, '17Spotangel, you really are an angel. God bless you and everyone who practices nursing like you do.
Unexpected death is surreal, and pulls the rug right out from under your feet. I'm stuck in my 3rd grief-funk, mourning a death that just keeps on giving.
What you did for Ron's sibs was beyond noble.
Kindness costs nothing, but it seems there is such a deficit in the world lately that any example of goodwill shown to someone else is truly extraordinary.
That day you did something wonderful. Good job nurse!Mar 28, '17It takes an expert, even gifted, manager to know when a power struggle over enforcing a rule will just escalate the damage being done and to go ahead and break it. Compassion (not pity) + skills = a truly kick-ass nurse. Without this intervention, that family might have been suffering from their totally natural denial for way too long. Impacted grief is not a good thing.Last edit by heron on Mar 28, '17Mar 28, '17Quote from NotAllWhoWandeRNWouldn't have a clue ... the issue might be that the morgue was never set up to allow public access, for administrative, financial or even forensic reasons. It's a pity that the facility had no mechanism for visiting remains that had already been transported out of the ED or off the unit. That exposure to the physical reality of death is important, in my view, in helping survivors cope with the fallout of such a big loss.Why would people need "special circumstances" to see the body of a loved one?Mar 28, '17To OP - Thank You for your caring presence. I believe there was certainly a moving reason why you felt impelled to work on that Sunday. And it was so fortunate that you did. But what if you hadn't?
Your last paragraph said it all. But I really didn't see it working UNTIL you appeared on the scene to provide the common sense, compassion and rule- bending that was obviously so needed.
Not your fault that you walked into a disturbing situation. There was escalating Crisis, but no obvious Recognition, minimal Prevention, and lacking effective Interventions (until you). Personally, I find that upsetting.
It just seems to me that everyone was 'just following the rules' because 'it's always been that way'. I will concede that you faced a very different & unique type situation.
I hope that all your participatory individuals had a chance to meet to review the situation and learn from it. Not until YOU took charge, did the situation change course. They were struggling, but it looks like UNNECESSARILY. And it was the family who was REALLY, REALLY struggling.
Again, thank you for your caring, wisdom, sanity, maturity, risk taking, etc. I'm sure the family appreciated it finally in their own ways.Mar 29, '17Thank you! I don't take life for granted and enjoy everyday with my friends and family as if it was my last day! Then when you or your loved one passes you have very little regrets just sorrow that heals with time!Mar 29, '17The morgue is not easily accessible.So our policy is a guideline that we use to make a judgement on safety. When a loved one is viewed in the morgue, any unexpected reaction can happen like fainting, falling, throwing themselves over the body, chest pain, lashing out to staff etc. So I have to make a decision not just clinically but also think of all potential scenarios and weigh the pros and cons. Sometimes a pt's body has been kept for over 5-8 hrs to accommodate family that is coming, but as an administrator I have to make sure the hospital is also not put at risk, old frail pts in the ED waiting for a bed for 2 days are not waiting another 8 hrs for that bed etc.Everything has to be taken into account.So 'special circumstances" is a judgement call based on what is happening that day.Most times family is given adequate notice before we move the body to the morgue. In this case, I made the decision as the pt was missing for five days and the phone number in the system for next of kin was not working, so the family came to know when they arrived in the ED to ask which room the pt had been admitted to.He died at home and was transported by Medics and arrived DOA.Mar 29, '17Only if the patient has no ID and or was not able to identify themselves. This pt was picked up from his current address and everything else on his ID matched our EMR. So we were pretty confident that we had the right patient.Mar 29, '17Been there too....
Sometimes we have to remember what it means to be a nurse......
Great job!Mar 29, '17Quote from NotAllWhoWandeRNIf the body is in the hospital morgue, there may be hospital policies against visitors in the morgue. Sometimes, in the case that a family member is required to identify a John Doe, they may be allowed to do so, but usually there's a procedure in place for this eventuality. Once the identification has been made and the body has been released to a funeral home, that is the place for the relatives to view the body. Allowing five special needs visitors to visit a hospital morgue that isn't set up for ANY visitors is a recipe for disaster.Why would people need "special circumstances" to see the body of a loved one?Mar 29, '17Really?! your trying to find fault? God Bless spotangel as a psych nurse of 29 years her handling of the situation was "Spot on"
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