Neuro ICU - Do you talk to brain-dead patients?

It was mostly refraining from talking to the kids in front of their parents. If the parents were holding out hope in the face of properly-done brain death criteria and a signed death certificate, my talking to their kid was only going to confuse them. Those parents tended to get more agitated if I spent much time out of the room, in case I "missed" something or failed to do something for their kid that would help them get better. I would spend extra time IN the rooms, but would try to make a point of sitting down to talk to the parents, giving at least the unconscious impression that my work was finished (if that makes sense).

But like I said, for a family like mine, who had a grasp on the finality of the situation, I always talk. And I'll do pretty much anything that makes the family feel better. I've held hands with the priest and said prayers, I've shaved a baby's head, I've made pink and purple hand prints of a 16 year-old girl because her mama wanted them.

The biggest thing is education. I find that most people have no idea what death is going to look like, especially death after withdrawl on a brain dead kid. They often expect gasping and moaning, and the eerie stillness after that tube is pulled can be really scary for them. I always make sure I explain that they won't breathe, but that it could take some time for the heart to stop. And then we decide together how long they want to stay. I had one daddy decide that he wanted to be the one to know first, and he didn't want me telling him. So when we pulled the tube, he curled up next to his daughter, his head on her chest, not moving a muscle. Ten minutes later, he finally lifted his head to tell me that she was gone, that he couldn't hear anything anymore. I saw him later that year at our memorial service, and he told me that being able to do that let him feel like he had some tiny measure of control when his life was spinning out of his grasp.

I've been out of the PICU world for almost 2 years now, working on a hospital ship in West Africa, and I really do miss it sometimes.

You sound like a fantastic nurse.

Thank you for sharing that, AliRae. It was very touching.

As for me talking to brain dead patients? Sure do. I also like to give them a good bath and shave if needed before we withdraw.

I still talk to my brain dead patients, but I think you have to be careful if family is present if they are unrealistic about condition / prognosis.

Hi Guys,
Interesting Discussion!!
For some reason reading some of the post I get the impression that some nurses believe that the patient is "still there", please remenber that once someone had been declared "brain death"...that is, they are DEATH.
Personally I still talk to my brain death patients...but out respect for them. As Kristyn mentioned, I have to be careful of doing that in front of the family.