Odd question about death/deceased person's body

Nurses General Nursing

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Specializes in Cardiac step down unit.

Please forgive me if this is a dumb question, I'm a PCT and a nursing student............so I'm looking for all of your RN wisdom.

How long should a deceased person's body be allowed to remain in the hospital room before they have to be bagged and transported to the morgue? At my hospital, the rule I have ALWAYS heard is that the body has to be off the floor by 4 hours after expiring. I work in Oncology so we have quite alot of patients passing and in all of the post mortems I have done (alot) they have been taken down by 3 hours.

I'm asking this because we had a patient pass, all the family but one son was present. The son was on a plane flying in to see her but he didn't make it. That being said................before our nurse manager left for the day she said the patient could remain in the room until the son arrived, that there was no law that stated they be removed in 4 hours. This is contrary to everything we (our RN's included) have always heard. So we bathed her, removed cath, etc. at about 1 hour post death. The son arrived at 6 hours after time of death. We didn't get to remove patient until 6 1/2 hours after time of death...............NEEDLESS to say, this was disturbing. Rigor had already started to set in, smell started to be very malodorous, etc.

Also, time of death "appeared" to be altered on paperwork.......I know because I was just outside the room when my patient passed.

What do you guys think??

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I've had deceased pts stay on the floor for over 8 hours. Sometimes it took family a long time to get there, or took them a long time to say their good byes. One time it took the funeral home a long time to get there (out of town funeral home, flash flood washed out bridge, ended up taking over 6 hours for the guy to travel a route that typically takes less than 2). The deceased ended up staying on our floor for almost 12 hours. We have a very, very small morgue. It was just easier on the family who was waiting for the funeral home if we let them stay in the room.

What's the point of having them leave within 4 hours? So what if rigor sets in? Apply some nicely scented lotion, have a fan going, spray some air freshener, and let the family have the time they need. It doesn't happen very often that they stay terribly long.

Maybe there is some rationale for your 4 hour rule. I've never heard it, though. The only reason I can see is to free up a bed and staff, not for the health or the well being of pts and their families.

I can't address the alteration of time of death without more detail into why you think it may have been altered. Maybe two RNs didn't call it immediately, maybe the doc didn't call it immediately, maybe someone wrote it down wrong. Who cares if the time of death is at 1400 or 1600? What difference does it make in an anticipated death? Don't you watch M*A*S*H?! ;) The time of death can be subjective, and unless there is a coroner's case or some obvious attempt at fraud going on, I don't see really why it makes any difference whether the pt stays in the room for 1 or 6 hours after expiring, or that the time of death is exactly what it was.

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I can imagine 4 hours in more of a hospital policy than a law. I believe exceptions should be made in this case. It probable meant a lot for the son to see her and it was on 2 or 3 more hours. The policy is probably in place to clear the room and allow more time to clean it so it can be refilled. As a nurse, I certainly wouldn't change the time of death because of this. It is simply a policy that was broken due to family circumstances and approved by the manager. If I thought it was a law, as the nurse I would have documented that I had spoken about it to the manager and she approved it. :twocents:

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I agree with qj - we have no limit. Sometimes we've waited for 6 hours or so for family to say goodbye. Post mortum care (bathing, lotion, powder) usually takes care of the odor. Open windows, fans, etc., could also help.

We live in a rural area - sometimes the mortuary that people choose is 80 miles away.

Used to be bodies stayed in homes for days for mourning.

I wonder where the 4 hour rule came from? There is no law that I know of that states that. Especially if you are waiting for the mortuary and they extend the 4 hour limit . . .. what are you going to do with the body if the hospital doesn't have a morgue?

steph

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Specializes in Emergency & Trauma/Adult ICU.

Your 4-hour "rule" is simply the typical practice of that particular unit of that particular hospital. As long as it wasn't severely constraining the ability of the unit to take new admissions, I don't see the problem. When we care for the sick, we also anticipate the needs of the dying/deceased patient and their family.

The vast majority of these situations are resolved in 4 hours or less. But for the occasional situations where this does not happen, some flexibility on the part of the staff can make a permanent difference in the grieving process of the family members. Think this through to its logical conclusion: would you have preferred to say directly to family members, "It's been 4 hours, we must now take (deceased patient) to the morgue." ?

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I can imagine 4 hours in more of a hospital policy than a law. I believe exceptions should be made in this case. It probable meant a lot for the son to see her and it was on 2 or 3 more hours. The policy is probably in place to clear the room and allow more time to clean it so it can be refilled. As a nurse, I certainly wouldn't change the time of death because of this. It is simply a policy that was broken due to family circumstances and approved by the manager. If I thought it was a law, as the nurse I would have documented that I had spoken about it to the manager and she approved it. :twocents:

Absolutely - changing documentation is simply wrong.

And this does sound to me like policy rather than law.

steph

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I think that must be hospital policy. The only time this would have been an issue in my hospital career was one very sad and touching case.

A woman in her 40's passed away with liver CA. She had been in so much pain that her husband could hardly touch her. After she expired, he crawled into the hospital bed with her and held her body for hours. There was no way anyone was going to go in and drag him away from her to remove her body. We allowed him to take as long as he needed to be close to her one last time and say his goodbyes. :crying2:

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Specializes in Community Health, Med-Surg, Home Health.

I don't know of a limit, but I have seen where they have moved the body to a private room so the other patients are not distressed seeing that someone has died; but that was at a nursing home. My father in law was placed in a room that had an air conditioner going strong, but we got there within a few hours.

I would do the best I can to honor the family's wish to bring closure, but I understand how you feel...the smell can be horrible, and it is not pleasent for the other patients or staff. In addition, as sad as it is, many times, you need the bed.

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at the hospice facility I go to 12 hours is the max.. we turn the air way down, and we do bed bath with generous powdering. I have only seen someone stay the full 12 hours but it was fine.

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I have not dealt very often with dead bodies. Is the smell really bad after just a very short time? Is it from super rapid decay or is it from the illness that killed the person?

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I have not dealt very often with dead bodies. Is the smell really bad after just a very short time? Is it from super rapid decay or is it from the illness that killed the person?

you can start noticing the smell around 5-6 hrs after death.

the decay you speak of, is called putrefaction, and usually takes 2-3 days for that process to start.

and finally, our med'l director told us the smell is due to anaerobic bacterial invasion.

don't really understand the process, but get the gen'l idea.

leslie

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I do not work in a hospital but a nursing home. We once had an experience where a family had not made any arrangements and could not decide what funeral home to use. The lady passes away around midnight and did not end up leaving our facility until 7am. All we did was put her in a room with no one else in it, shut the door and put on the air conditioner since it was late summer. Everything worked ok.

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