Pronouncing patients death

zanfelhor · Jul 12, 2013

I live in florida, am an LPN, there must be two LPNs, or one RN to pronounce

NC29mom, ASN, LPN, RN · Jul 12, 2013

In NC only a RN can pronounce death in our hospice setting. This is why we don't use LPNs to do our call. We, of course, have to have several things present (absent pulse, BP, etc).

If there's a DNR in the home, there's never an issue. The hospice company I work for allows us to go to a death call, and if the family agrees, not initiate CPR (we call dr and get verbal for DNR, to pronounce, and release body to funeral home). However, I used to work for a cmpy who insisted the family call 911 if there wasn't a DNR in the home, even if the family/PCG didn't want CPR. We try our best to get DNRs in the home ASAP, but there will always be "that family/that patient, who waits until the very end. ......

TBlase · Jul 12, 2013

i am an lvn in hospice in ca, i have pronouced 2 in the past 48hrs. It is done by.the nurse as a order that the dr signs later like a voice order

An LVN cannot 'pronounce' death. In most states an RN cannot 'pronounce' death, and in those that they can, most require verification by another qualified, licensed person- it's a big deal, really, regardless of how many people die on you routinely. An LVN can (in states where it is allowed) write a telephone order indicating that 'death was pronounced by the physician', a very different situation. Whatever type of place you work for surely has a specific, legal procedure to follow. Might want to peruse your state's nurse practice act. A lot rides on that 'pesky' final statement of death.

TBlase · Jul 12, 2013

Maybe it was just hospital policy. I would like a more definite answer, though, so I'll see if I can find it. Thanks!

Better to be safe than sorry. I'm sure you don't want supoenaed as the nurse (with 5000 posts!) that decided a patient was dead, yet then he started moving at the morgue? I'm just saying- if there's ever a time to follow protocol to the strictest letter, it must be when you think a person has died. It also amazes me the number of nurses that believe a DNR means 'don't call the doctor is the patient is short of breath', or whatever? Wow. Small wonder the lawyers are getting fat.

curiousauntie · Jul 12, 2013

In NJ an RN can pronounce death in long term care facilities or if the patient is at home only if they are on hospice. I'm presently in hospice, but also worked in OFF for many years. We then initiate the death certificate as the pronounced. Tue doc still has to certify cause of death and sign the certificate. I'm not sure of the protocol in hospitals.

curiousauntie · Jul 12, 2013

Sorry, OFF should be LTC...loving that autocorrect!

hospicern030363 · Jul 13, 2013

Where I work in Oregon, RN's can pronounce hospice pt's. Our state leaves it up to the coroners in each county.

DLS_PMHNP, MSN, RN, NP · Jul 14, 2013

I live in Michigan; when I worked at an inpatient facility, I could pronounce death (no one else needed to witness).

I'm working home hospice now, and I can pronounce there too, without a second person.

ambrosial · Jul 15, 2013

Thank you all for your responses. I will definitely email the Ca boards. I have continued to search with no avail.

SaoirseRN · Jul 15, 2013

I work in acute care and we require a physician's order. The "nurse to pronounce" order is part of our preprinted palliative (hospice) orders, but sometimes for an unexpected but not surprising death (DNR patient) they'll give the order when we phone to notify them if they don't feel they need to come pronounce themselves

ambrosial · Jul 24, 2013

Hello all! I actually wrote to California Board and asked. The answer is yes nurses can pronounce patients deaths, including in an acute setting. It is found in the RN Scope of Regulation Business and Professions Code Section 2725 and the Standardized Procedure Guidelines.